Updated Adaptive Servo-Ventilation Recommendations for the 2012 AASM Guideline: "The Treatment of Central Sleep Apnea Syndromes in Adults: Practice Parameters with an Evidence-Based Literature Review and Meta-Analyses".
An update of the 2012 systematic review and meta-analyses were performed and a modified-GRADE approach was used to update the recommendation for the use of adaptive servo-ventilation (ASV) for the treatment of central sleep apnea syndrome (CSAS) related to congestive heart failure (CHF). Meta-analyses demonstrated an improvement in LVEF and a normalization of AHI in all patients. Analyses also demonstrated an increased risk of cardiac mortality in patients with an LVEF of ≤ 45% and moderate or severe CSA predominant sleep-disordered breathing. These data support a Standard level recommendation against the use of ASV to treat CHF-associated CSAS in patients with an LVEF of ≤ 45% and moderate or severe CSAS, and an Option level recommendation for the use of ASV in the treatment CHF-associated CSAS in patients with an LVEF > 45% or mild CHF-related CSAS. The application of these recommendations is limited to the target patient populations; the ultimate judgment regarding propriety of any specific care must be made by the clinician.
Johns Hopkins University, School of Medicine, Baltimore, MD.
R Nisha
RN
Aurora
University of Nebraska Medical Center, Omaha, NE.
Sabin R
SR
Bista
William S. Middleton Memorial Veterans Hospital, Madison, WI.
Kenneth R
KR
Casey
John D. Dingell VA Medical Center and Wayne State University, Detroit, MI.
Susmita
S
Chowdhuri
University of Pittsburgh, Pittsburgh, PA.
David A
DA
Kristo
Mayo Clinic Florida, Transplant Center, Jacksonville, FL.
Jorge M
JM
Mallea
Mayo Clinic, Rochester, MN.
Kannan
K
Ramar
Department of Medicine, Wayne State University School of Medicine, Detroit, MI.
James A
JA
Rowley
Sleep Disorders Center, University of California, San Francisco, San Francisco CA.
Rochelle S
RS
Zak
American Academy of Sleep Medicine, Darien, IL.
Jonathan L
JL
Heald
D000047:Academies and Institutes; D000328:Adult; D019317:Evidence-Based Medicine / Q000379:methods*; D006801:Humans; D017410:Practice Guidelines as Topic; D012121:Respiration, Artificial / Q000379:methods*; D020182:Sleep Apnea, Central / Q000628:therapy*; D014481:United States
adaptive servo-ventilation; central sleep apnea; clinical practice guideline