Comparison of Auto- and Fixed-Continuous Positive Airway Pressure on Air Leak in Patients with Obstructive Sleep Apnea: Data from a Randomized Controlled Trial
Comparison of Auto- and Fixed-Continuous Positive Airway Pressure on Air Leak in Patients with Obstructive Sleep Apnea: Data from a Randomized Controlled Trial
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DOI：
10.1155/2019/6310956
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发表时间：
2019-08-07
影响因子：
2.2
通讯作者：
Borel, Jean-Christian
中科院分区：
文献类型：
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作者：
Lebret, Marius;Rotty, Marie-Caroline;Borel, Jean-Christian
由于压力变化和意外泄漏，自动CPAP可能会导致睡眠碎片。本研究的目的是比较固定CPAP和自动CPAP治疗4个月后的漏气情况。这项研究是一项为期4个月的随机、双盲、平行、对照试验的辅助分析，比较了固定CPAP和自动CPAP在新诊断的阻塞性睡眠呼吸暂停患者中的作用。从CPAP设备中提取以下数据：平均压力和第90百分位数、剩余呼吸暂停低通气指数、平均CPAP使用量和漏气量。在每一组中，患者也被随机分配使用三种不同品牌的设备之一。由于每个设备的泄漏报告不同，因此确定了每个品牌的中位数泄漏值，并将泄漏分类为“高于中位数”或“低于中位数”。对269例患者的数据进行了分析。单变量分析显示，烟草消费、CPAP水平和口罩与CPAP中值以上的泄漏有关，但与CPAP的类型无关。多变量分析显示，只有CPAP水平和口鼻面罩与中位数以下的渗漏有关。固定CPAP和自动CPAP使用的面罩类型没有差异。CPAP的类型对泄漏或使用的接口类型没有影响。我们使用一种基于中位数泄漏值的方法来标准化不同设备之间的比较，这些设备报告具有不同定义的泄漏。
Auto-CPAP may cause sleep fragmentation due to variations in pressure and unintentional leaks. The aim of this study was to compare air leak between fixed-CPAP and auto-CPAP after 4 months of CPAP treatment. This study is an ancillary analysis of a randomized, double-blind, parallel, controlled trial over 4 months, comparing fixed- and auto-CPAP in newly diagnosed patients with OSA. The following data were extracted from the CPAP devices: mean and 90th percentile pressure, residual apnea-hypopnea index, mean CPAP use, and amount of leak. Within each arm, patients were also randomly allocated to use of one of the three different brands of devices. Since the leak was reported differently for each device, median leak value was determined for each brand and leaks were classified as "above the median" or "below the median". Data from 269 patients were analyzed. The univariate analysis showed that tobacco consumption, CPAP level, and oronasal masks were associated with leaks above the median value but not the type of CPAP. The multivariate analysis showed that only CPAP level and oronasal masks were associated with leaks below the median. There were no differences in the types of mask used between fixed- and auto-CPAP. There was no impact of the type of CPAP on leaks or the type of interface used. We used a method based on the median leak value to standardize comparisons across devices which report leaks with different definitions.