PT  - JOURNAL ARTICLE
AU  - Vratislav Sedlák
AU  - Ondrej Kudela
AU  - Michal Kopecký
AU  - Michal Svarc
AU  - Petr Smolík
AU  - Vít Havel
TI  - Factors influencing efficacy of BiPAP therapy in severe obstructive sleep apnea
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P4040
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P4040.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P4040.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - Introduction and background: Severe obstructive apnea is current medical problem associated with obesity epidemic. There is frequently observed failure of bi-level positive pressure support therapy in patient with obesity and comorbidities as bronchial obstruction, cardiac failure.Aims and objectives: Our hypothesis was that comorbidities, excessive daytime sleepiness (EDS, Epworth Sleep Scale), obesity and bronchial obstruction influences failure of BiPAP as a first choice therapy and requires volume assisted non-invasive ventilation (AVAPS). We compared these parameters in 32 consecutively examined patients reffered for obstructive sleep apnea syndrom to sleep lab and recieved BiPAP (n=17) or AVAPS (n=15) due to insufficent efffect of BiPAP. Results: BiPAP and AVAPS groups did not differ in gender, age, BMI, comorbidities (stroke, coronary, hearth, disease, obstructive lung disease) and smoking history (all p>0.05). In AVAPS group was higher t90% (percentage of time below 90% oxygen saturation) (66.6 vs 46.1, p=0.03), EDS (p=0.03), apnea/hyponea index were compareble (58.7 vs 48.9, p=0.17). In AVAPS group were lower FEV1% (51.4% vs 67.8%, p=0.01). Conclusion: Severe obstructive sleep apnea is frequently associated with comorbidities. Presence of higher bronchial obstruction plays a role in a potential failure of BiPAP as a first line therapy. Future studies are needed to assess efficacy of bronchodilatation therapy in improvement of efficacy and adherence to BiPAP.