The ImPAP-mode – a new therapy for Cheyne Stokes respiration

[North_Moon]

The ImPAP-mode – a new therapy for Cheyne Stokes respiration

Stefanie Boecker,1 Heinrich Wenz, Ekkehard Gruenig, Felix J.F. Herth.. 1Pneumology, Thoraxklinik
Heidelberg, Heidelberg/Baden-Wuerttemberg, Germany.
Background: Patients with central sleep apnea (CSA) and Cheyne Stokes Respiration (CSR) are common in
chronic left heart failure (CHF) and neurological diseases or occur without any known reasons. CSA and CSR
lead to a progress of the heart disease and may induce other chronic diseases as systemic arterial hypertension
or diabetes. Conventional treatment of the CSA/CSR includes a systemic therapy of the heart disease and the
Anti-Cyclic assisted ventilation.
Impulse-positive airway pressure (ImPAP) stimulates in case of central apnea the breathing center in the brain
stem with impulses, which stimulate receptors in the soft palate. The impulses are added to an automatically
titrated CPAPpressure.
Aims and objectives: The aim of our study was to analyse the effect of ImPAP on the apnea hypopnoe index
(AHI), the NTproBNP and the acceptance of therapy.
Methods: We assessed 60 patients with various forms of CSA. After diagnostic- and titration-night under
polysomnographic conditions, every patient received ImPAP during one night in hospital. The AHI before and
after therapy, the time of use per night during the first four weeks and in those patients with CHF the NTproBNP
was analysed.
Results: In 57 of 60 patients ImPAP has been performed sufficiently. Two patients had to change therapy, one
refused therapy. The AHI was significantly reduced from 41,9/h to 4,1/h (p< 0,05). The acceptance of therapy was
high with a mean use of 5,9h/night. The 8 patients with CHF showed a significant reduction of NTproBNP up to
50%.

[avi123]

The above is from 2008.

http://www.ersnet.org/learning_resource ... les/62.pdf

[SleepyToo2]

The correct citation source can be found on PubMed http://www.ncbi.nlm.nih.gov/pubmed/18024166. The full article was actually published in August 2008 in Sleep Medicine (with online publication in November 2007), but there was an abstract presented at ERS (European Respiratory Society) in November 2008. Pays to check dates these days - I saw it earlier today but didn't realize the date.