Equivalence of nasal and oronasal masks during initial CPAP titration for obstructive sleep apnea syndrome.
Equivalence of nasal and oronasal masks during initial CPAP titration for obstructive sleep apnea syndrome.
复制标题
阻塞性睡眠呼吸暂停综合征初始 CPAP 滴定过程中鼻罩和口鼻罩的等效性。
作者：
Ming Teo;T. Amis;Sharon A. Lee;K. Falland;S. Lambert;J. Wheatley
研究目的
持续气道正压通气（CPAP）滴定研究通常使用鼻罩进行，但有些患者可能更喜欢全脸或口鼻面罩。几乎没有证据表明用于启动治疗的不同面罩接口具有等效性。我们假设使用口鼻面罩时口鼻呼吸会增加上气道的通畅性，并且可能需要更高的压力来维持气道通畅。我们还评估了患者对2种面罩界面的偏好。
设计
前瞻性、随机、交叉设计，连续2个CPAP滴定夜。
设置
大学医院认可的实验室。
患者或参与者
24例阻塞性睡眠呼吸暂停综合征和呼吸紊乱指数大于15起事件/小时的初治受试者。
干预措施
使用自动滴定机进行CPAP滴定，随机分配至鼻或口鼻面罩，然后使用替代面罩类型进行第二次滴定。
测量和结果
虽然43%的受试者的鼻-口鼻面罩压力差为2 cm H2 O或更大，但鼻-口鼻面罩之间的平均压力没有显著差异。使用口鼻面罩时，残余呼吸事件、觉醒和测得的泄漏都更大。79%的受试者更喜欢鼻罩。
结论
阻塞性睡眠呼吸暂停综合征患者通常可以在不改变机器压力的情况下在鼻罩和口鼻罩之间切换，尽管存在可能具有临床意义的个体差异。使用口鼻面罩时测得的泄漏更大。大多数阻塞性睡眠呼吸暂停综合征患者更喜欢使用鼻罩作为CPAP启动的接口。
临床试验注册
澳大利亚新西兰临床试验注册中心（ANZCTR）。ACTRN：ACTRN 12611000243910。网址：http://www.ANZCTR.org.au/ACTRN12611000243910.aspx
STUDY OBJECTIVE
Continuous positive airway pressure (CPAP) titration studies are commonly performed using a nasal mask but some patients may prefer a full-face or oronasal mask. There is little evidence regarding the equivalence of different mask interfaces used to initiate treatment. We hypothesized that oronasal breathing when using an oronasal mask increases upper airway collapsibility and that a higher pressure may be required to maintain airway patency. We also assessed patient preferences for the 2 mask interfaces.
DESIGN
Prospective, randomized, cross-over design with 2 consecutive CPAP titration nights.
SETTING
Accredited laboratory in a university hospital.
PATIENTS OR PARTICIPANTS
Twenty-four treatment-naive subjects with obstructive sleep apnea syndrome and respiratory disturbance index of greater than 15 events per hour.
INTERVENTIONS
CPAP titration was performed using an auto-titrating machine with randomization to a nasal or oronasal mask, followed by a second titration night using the alternate mask style.
MEASUREMENTS AND RESULTS
There was no significant difference in the mean pressures determined between nasal and oronasal masks, although 43% of subjects had nasal-to-oronasal mask-pressure differences of 2 cm H(2)O or more. Residual respiratory events, arousals, and measured leak were all greater with the oronasal mask. Seventy-nine percent of subjects preferred the nasal mask.
CONCLUSIONS
Patients with obstructive sleep apnea syndrome can generally switch between nasal and oronasal masks without changing machine pressure, although there are individual differences that may be clinically significant. Measured leak is greater with the oronasal mask. Most patients with obstructive sleep apnea syndrome prefer a nasal mask as the interface for initiation of CPAP.
CLINICAL TRIAL REGISTRATION
Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN: ACTRN12611000243910. URL: http://www.ANZCTR.org.au/ACTRN12611000243910.aspx
与睡眠期间上呼吸道闭塞相关的神经和解剖因素。
DOI：
10.1016/s0025-7125(16)30984-1
发表时间：
1985
期刊：
The Medical clinics of North America
影响因子：
--
作者：
Kuna,ST;Remmers,JE
通讯作者：
Remmers,JE