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The prediction of treatment failure of the continuous positive airways pressure

Publication at Faculty of Medicine in Pilsen |
2014

Abstract

Abstract: Objective: The aim of study was to fi nd predictive factors for treatment failure of the continuous positive airway pressure (CPAP). Background: Sleep apnea syndrome (SAS) affects 4-8 % of the general population.

Despite good adherence, CPAP is ineffective in about 13 % of patients. In those patients, a higher level of treatment by bilevel positive airway pressure (BiPAP) has to be used.

Methods: Totally, 983 patients with moderate to severe SAS (AHI GREATER-THAN OR EQUAL TO 15, apnea/hypopnea index) were treated with CPAP during 2005-2010 in a tertiary hospital. 506 patients fulfi lled the inclusion criteria. In all patients, sleep monitoring was performed and AHI, the presence of hyposaturation T90 (oxygen saturation less than 90 %) and ODI (oxygen distress index) were recorded and a comparison was made between CPAP-effective and CPAP-failure treatment groups.

Results: Of all the variables evaluated, only T90 signifi cantly predicted the failure of CPAP treatment. A T90 value above 43.5 % predicted CPAP failure in 94.5 % of patients regardless of age.

Conclusions: The value of T90 enables the determination of patients who will not benefi t from CPAP treatment and BiPAP should be used as a treatment of the fi rst choice (Tab. 2, Fig. 1, Ref. 31). Text in PDF www.elis.sk. .