title: [Noninvasive ventilation: efficacy of a new ventilatory mode in patients with obesity-hypoventilation syndrome].
abstract: Noninvasive ventilation is recommended to correct the nocturnal hypoventilation and relieve the symptoms of patients with the obesity-hypoventilation syndrome (OHS). The benefits of fixed pressure ventilation (S/T technology) are recognized but limited on account of the variability of nocturnal ventilatory requirements. The new technique AVAPS-AE (automatic EPAP) allows adjustment of the pressure according to the volume currently targeted. Its efficacy has not yet been evaluated. Our objectives are to evaluate firstly, whether AVAPS-AE optimizes the benefits of S/T technology on sleep architecture and quality, secondly, whether these benefits are associated with an improvement in gas exchange, symptoms, exercise tolerance, level of physical activity and quality of life of patients with OHS. In this multicenter trial, 60 newly diagnosed patients with OHS will be randomized to the control (S/T) and trial (AVAPS-AE) groups. A standardized titration procedure will be followed for the calibration of the ventilators. Functional evaluations (polysomnography, blood gases, impedance measurements and walking tests), questionnaires (physical activity, quality of life, quality of sleep and daytime somnolence) visual scales (fatigue, headaches) and a recording of activity will be undertaken after two months of ventilation.
authors.affiliation: Fédération ANTADIR, 66, boulevard Saint-Michel, 75006 Paris, France. Electronic address: annabelle.couillard@yahoo.fr.
authors.forename: A
authors.initials: A
authors.lastname: Couillard
authors.affiliation: Laboratoire EFCR, CHU Michallon, coté Chartreuse, boulevard de La Chantourne, 38700 La Tronche, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Pepin
authors.affiliation: Service de pneumologie et réanimation respiratoire, CHU de Dijon, 14, rue Paul-Gaffarel, 21079 Dijon, France.
authors.forename: C
authors.initials: C
authors.lastname: Rabec
authors.affiliation: UPRES EA 3830, service de pneumologie et unité de soins intensifs respiratoires, CHU de Rouen, université de Rouen, 76031 Rouen, France.
authors.forename: A
authors.initials: A
authors.lastname: Cuvelier
authors.affiliation: UPRES EA 3830, service de pneumologie et unité de soins intensifs respiratoires, CHU de Rouen, université de Rouen, 76031 Rouen, France.
authors.forename: A
authors.initials: A
authors.lastname: Portmann
authors.affiliation: UPRES EA 3830, service de pneumologie et unité de soins intensifs respiratoires, CHU de Rouen, université de Rouen, 76031 Rouen, France.
authors.forename: J-F
authors.initials: JF
authors.lastname: Muir
mesh_terms: D000403:Airway Resistance; D001331:Automation; D001784:Blood Gas Analysis; D006970:Disorders of Excessive Somnolence / Q000209:etiology; D004867:Equipment Design; D017079:Exercise Tolerance; D045853:Exhalation; D005221:Fatigue / Q000209:etiology; D006261:Headache / Q000209:etiology; D006801:Humans; D001239:Inhalation; D063087:Noninvasive Ventilation / Q000379:methods*; D010845:Obesity Hypoventilation Syndrome / Q000097:blood / Q000150:complications / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D018579:Patient Selection; D017286:Polysomnography; D011175:Positive-Pressure Respiration / Q000379:methods*; D011788:Quality of Life; D012107:Research Design; D011795:Surveys and Questionnaires
keywords: Activité physique; Noninvasive ventilation; Obesity-hypoventilation syndrome; Physical activity; Quality of life; Qualité de vie; Sleep; Sommeil; Syndrome obésité-hypoventilation; Ventilation non invasive