Optimal pressure in obstructive sleep apnea: auto-titrating positive airway pressure versus predictive equations
| Autor: | Iman Galal, Haytham S Diab |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | Egyptian Journal of Chest Disease and Tuberculosis, Vol 70, Iss 1, Pp 99-106 (2021) |
| Druh dokumentu: | article |
| ISSN: | 0422-7638 2090-9950 |
| DOI: | 10.4103/ejcdt.ejcdt_108_20 |
| Popis: | Background The prescription of equation-based predicted pressure (Ppred) using mathematical equations has been proposed as a practical strategy for the determination of effective positive airway pressure (PAP). This study aimed at comparing the differences between therapeutic pressures obtained by auto-titrating positive airway pressure (APAP) and 10 predictive mathematical equations among Egyptian patients with obstructive sleep apnea (OSA). Patients and methods A retrospective cross-sectional study included 25 PAP-naïve patients (23 males and two females) with polysomnographically confirmed OSA. The 95th percentile pressure (P95) of an APAP device during an attended successful titration study was selected as the effective reference PAP, against which PPred calculated from ten predictive equations was compared. Results Among the 25 patients included, four patients had mild, eight had moderate, whereas the remaining 13 patients had severe OSA. The mean P95 was higher than all predictive equations. A total of 24 (96%) of the 25 included patients experienced acceptable air leak during APAP titration. P95 correlated significantly and positively with pressures calculated by most of predictive equations except for those of equations 2, 6, and 7. Comparison between P95 and Ppred showed nonsignificant statistical difference for pressure calculated by Sériès equation, whereas Ppred of other equations were significantly lower than P95. Mean pressure difference between P95 and Ppred was around three in most of the equations with Sériès equation carrying the least mean pressure difference (0.7 cmH2O). Conclusion P95 is higher than Ppred, yet Sériès equation was the closest to P95. The utility of predictive equations for determining effective PAP level can serve a beneficial role during titration studies and can be used with caution as a practical alternative for PAP titration. |
| Databáze: | Directory of Open Access Journals |
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