The Science Journal of the American Association for Respiratory Care

2003 OPEN FORUM Abstracts

ADAPTIVE SERVO VENTILATION IMPROVE PATIENTS WITH CONGESTIVE HEART FAILURE AND CHEYNE-STOKES RESPIRATION

GUO Xiheng, Chen W, Hongyu Z, Weimin K, Li A, Li L, Xinzhi W
Beijing Chaoyang Hospital-Beijing Institute of Respiratory Medicine
Affiliated Capital University of Medical Sciences
Beijing 100020, P.R. China

Introduction: Cheyne-Stokes respiration in patients with CHF is associated with increased mortality. We hypothesized that long-term adaptive servo ventilation(ASV) may depress CSR, improve cardiac function and sleep architecture in patients with congestive heart failure (CHF).

Methods:
36 patient with stable CHF (NYHA II~III), , aged 64.4±8.0; BMI 28.7±4.0; ejection fraction (EF) 36.4±13.3 were treat with adaptive servo ventilation (AutoSet CS, ResMed, Australia) for 1 months. Overnight polysomnograms were performed before and after treatment.

RESULTS:
Adaptive servo ventilation effectively suppressed CSR for all 36 patients from the first night on. CSR index decreased from 35.7±17.6 to 0.3±1.5; oxygen desaturation index (ODI) dropped from 43.1±21.2 to 2.5±3.9; The lowest saturation increased from 69.0±15.4 to 91.7±3.5. percentages of slow-wave-sleep (SWS) increased from 2.3±1.5 to 8.6±4.3. After 1 months treatment, EF increased from 34.7+15.1 to 47.2+16.1.Arousal index, sleep efficiency, scores on Epworth sleepiness Scales were improved significantly.

Conclusions:
Nocturnal ASV have significant effect on the outcomes in patients with CSR. Long-term overnight ventilatory therapy can improve cardiac function and sleep quality in stable CHF patients with CSR.

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