title: Respiratory effects of adaptive servoventilation therapy in patients with heart failure and Cheyne-Stokes respiration compared to healthy volunteers.
abstract: BACKGROUND
  Nocturnal adaptive servoventilation (ASV) therapy is now frequently used to treat Cheyne-Stokes respiration (CSR), which is highly prevalent in patients with moderate-to-severe heart failure (HF) and characterized by periodical breathing (hyperventilation).
  
  
  OBJECTIVE
  This study analyzed and compared the acute effects of a novel ASV device on carbon dioxide pressure (pCO2) and oxygen saturation (SaO2) in HF patients with CSR and healthy volunteers. The influence of being asleep or awake on the ASV algorithm was also determined.
  
  
  METHODS
  All subjects underwent ASV (PaceWave™, ResMed) for 1 h. Transcutaneous pCO2 (PtcCO2) and SaO2 were assessed transcutaneously, while wakefulness was analyzed using EEG recordings. Assessments were made 30 min before and after ASV, and during 1 h of ASV.
  
  
  RESULTS
  Twenty HF patients (19 male; age 79 ± 12 years) and 15 volunteers (13 male, age 25 ± 4 years) were included. When awake, ASV was associated with a trend towards a decrease in PtcCO2 and an increase in SaO2 versus baseline in HF patients (34.4 ± 3.2 to 33.7 ± 3.8 mm Hg and 93.8 ± 2.6 to 94.9 ± 2.6%, respectively) and volunteers (39.5 ± 3.0 to 38.2 ± 3.8 mm Hg and 96.9 ± 1.3 to 97.8 ± 0.9%). While asleep during ASV, PtcCO2 increased to 36.3 ± 3.8 mm Hg and SaO2 decreased to 93.8 ± 2.6% in HF patients, with similar changes in volunteers (PtcCO2 41.7 ± 3.0 mm Hg, SaO2 97.1 ± 1.2). All comparisons were statistically significant (p ≤ 0.05, except the PtcCO2 decrease in both groups when awake).
  
  
  CONCLUSIONS
  ASV therapy might result in hyperventilation when subjects are awake, but while asleep, PtcCO2 increased to mid-normal values, effects that would be favorable in HF patients with CSR.
authors: Department of Cardiology, Heart and Diabetes Centre North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany.
authors: Jens
authors: J
authors: Spießhöfer
authors: Jessica
authors: J
authors: Heinrich
authors: Roman
authors: R
authors: Lehmann
authors: Christina
authors: C
authors: Efken
authors: Henrik
authors: H
authors: Fox
authors: Thomas
authors: T
authors: Bitter
authors: Britta
authors: B
authors: Körber
authors: Dieter
authors: D
authors: Horstkotte
authors: Olaf
authors: O
authors: Oldenburg
mesh_terms: D000328:Adult; D000368:Aged; D002245:Carbon Dioxide / Q000097:blood*; D002639:Cheyne-Stokes Respiration / Q000628:therapy*; D004569:Electroencephalography; D005260:Female; D064368:Healthy Volunteers; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D063087:Noninvasive Ventilation; D010100:Oxygen / Q000097:blood*; D012891:Sleep Apnea Syndromes / Q000628:therapy; D014851:Wakefulness
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen