RT Journal Article
SR Electronic
T1 Optimal pressure determination for CPAP in the treatment of obstructive sleep apnea syndrome (OSAS). Comparison of prediction equations and autoCPAP titration
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3580
VO 42
IS Suppl 57
A1 Berta Román
A1 Eva Maria Rosillo
A1 Luis Hernández
A1 Lucia Zamora
A1 Baeza Carlos
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P3580.abstract
AB To analyze whether there is a good correlation between the pressure setting by autoCPAP and the one calculated by mathematical prediction formulas proposed by Hoffstein et al.([(0.16xBMI)+(0.13xNC)+(0.04xAHI)-5.12], (AmJRespirCritCareMed1994) and Séries et al [(0.193xBMI)+(0.077xNC)+(0.02xAHI)–0,611] (Chest2008).Consecutive patients with OSAS diagnosis after a sleep study between December-2003 to December-2012. Patients underwent an attended sleep study for CPAP titration with an autoCPAP device (REMstar ®). The pressure was set from 4 to 15 cmH20. We analyze the correlations (Pearson r coefficient and Bland-Altman plots) between the pressure calculated by the formulas and the one obtained by autoCPAP.We included 2514 male patients. Mean values were: age 54 years±12.5, neck circumference(NC) 43.8±3.6 cm, BMI 33±6kg/m2; AHI 49±22. Although there was a good correlation between the pressures calculated by both formulas (r=0.97, p<0.0001), was lower among the pressures obtained by autoCPAP and Hoffstein (r=0.62, P<0.001) or Series (r=0.54, p<0.001). Comparing with the optimum pressure by autoCPAP, we found a difference ≥2cmH2O in 220 (19.8%) patients respect to Hoffstein formula (in 24 was higher and lower in the other 196 patients). By contrast, with the Séries formula there was a difference ≥2 cmH2O in 393 patients (in 356 was higher).When comparing with autoCPAP titration, Hoffstein formula underestimates CPAP pressure values >7cmH2O. The opposite happens with the Séries formula, which overestimates the pressure throughout the usual range of values except for pressures >12cmH2O.