ResMed's "failed" trial of ASV machines

Morbius wrote:So IOWs, ASV just makes the waveform look pretty.

Gee, I wish I thought of that.

At any rate, this is so not a surprise. The same conclusion was reached in CANPAP 10 years ago:

http://www.medscape.com/viewarticle/787437

However, there were plenty of other benefits in the CPAP users back then, and I'm sure with the ASV users now.

That link doesn't work for me unfortunately

Could you please tell me the name of the article?

Thank you

Further, I don't think there's any harm in spreading the word that

JustinD9 wrote:ResMed announced that its Serve_HF trial of its ASV machines... caused an increase in cardiovascular mortality.

I don't think CANPAP had anything to do with ASV though. So not the same conclusion.

sleepstar wrote:I don't think CANPAP had anything to do with ASV though. So not the same conclusion.

It is absolutely the same conclusion:

xPAP therapy does not improve mortality.

Morbius wrote:

sleepstar wrote:I don't think CANPAP had anything to do with ASV though. So not the same conclusion.

It is absolutely the same conclusion:

xPAP therapy does not improve mortality.

Ok.

Did the CANPAP study find increased mortality? I will look it up shortly. I hope they release some data soon. Very interested to see.

sleepstar wrote:Did the CANPAP study find increased mortality?

Interestingly, initially it did. This also brings to mind the big Yaggi study for OSA. I think what all these studies show is if you FU your body for 30 years, a deathbed confession don't help at that point.

Here's another link to the CANPAP trial (funded in part by Respironics) for those unable to get the Medscape article referenced by Morbius http://www.nejm.org/doi/full/10.1056/NE ... t=abstract . The Medscape is a little easier read for us non professionals. The results of the CANPAP trial may provide some perspective for the results of the ResMed trial.

sleepstar wrote: These findings really scare me. I hope they release some data soon. Very interested to see.

in other news, the sky is falling, film at 11.

palerider wrote:

sleepstar wrote: These findings really scare me. I hope they release some data soon. Very interested to see.

in other news, the sky is falling, film at 11.

How is that helpful?
The attitude of some people on this forum is terrible.

Jay Aitchsee wrote:Here's another link to the CANPAP trial (funded in part by Respironics) for those unable to get the Medscape article referenced by Morbius http://www.nejm.org/doi/full/10.1056/NE ... t=abstract . The Medscape is a little easier read for us non professionals. The results of the CANPAP trial may provide some perspective for the results of the ResMed trial.

Thanks for posting that. I'm really interested to know what the physiology is behind this. I'm sure it will take a long time though.

I note that Phillips has also released a statement similar to ResMed, saying that their machine is contraindicated in heart failure.

It is an awful feeling working around these machines and then having this data come out and really having no understanding why.

What I've read over the last day in journal articles (and admittedly it's not much) the findings seem to be that there is no difference in health outcome between ASV and CPAP compared to control. The SERVE-hf study has actually found an increased rate of mortality. It will be very interesting, and obviously beneficial, for us to know why this is.

Kind regards

sleepstar wrote:Thanks for posting that. I'm really interested to know what the physiology is behind this.

I would offer that the EPAP (at the least) ends up increasing PVR and puts additional strain on right heart.

Morbius wrote:

sleepstar wrote:Thanks for posting that. I'm really interested to know what the physiology is behind this.

I would offer that the EPAP (at the least) ends up increasing PVR and puts additional strain on right heart.

Yeah? I don't know much about the heart so I definitely cannot contribute anything there.

sleepstar wrote: All I heard from colleagues is that it may be due to pressure on the heart...

That would be a pretty safe position to take.

Morbius wrote:

sleepstar wrote:Thanks for posting that. I'm really interested to know what the physiology is behind this.

I would offer that the EPAP (at the least) ends up increasing PVR and puts additional strain on right heart.

For folks not up on the acronyms (like me), I googled PVR.

PVR = pulmonary vascular resistance

And my understanding (which is limited) is that PVR is a measure of the resistance that must be overcome to push blood through the lungs' circulatory system and create blood flow through the lungs. The right side of the heart pumps blood coming in from the body to the lungs so that the blood can be reoxygenated before it returns to the left side of the heart and is then pumped throughout the rest of the body.

I think the titration protocols need to looked at closely, specifically if they created a milieu that discouraged venous return (i.e., aggressive EPAP and baseline IPAP (vs. like PSmin = 0)).