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Somers, Virend, Arzt, Michael, Bradley, T. Douglas, Randerath, Winfried, Tamisier, Renaud ORCID: 0000-0003-1128-6529 and Won, Christine (2018). Servo-Ventilation Therapy for Sleep-Disordered Breathing. Chest, 153 (6). S. 1501 - 1503. AMSTERDAM: ELSEVIER SCIENCE BV. ISSN 0012-3692

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Abstract

As seen in this CME online activity (available at http://journal.cme.chestnet.org/sv-sleepdisorder), central sleep apnea (CSA) is associated with increased mortality in patients with heart failure (HF), and it has been thought that treatment of CSA may improve underlying HF. Positive airway pressure therapy, specifically auto-servoventilation (ASV), can not only suppress abnormal breathing patterns but has been reported to improve cardiac function in HF patients with CSA. In patients with HF and with CSA unsuppressed with CPAP, newer ASV use has been associated with significant CSA improvement; in addition, several studies have reported efficacy of ASV in the treatment of underlying cardiac dysfunction in HF patients with CSA. However, results from the large randomized Treatment of Sleep-Disordered Breathing with Predominant Central Sleep Apnea by Adaptive Servo-Ventilation in Patients with Heart Failure (SERVE-HF) trial (Cowie MR, Woehrle H, Wegscheider K, et al. Adaptive servo-ventilation for central sleep apnea in systolic heart failure. New Engl J Med. 2015; 373[12]: 1095-1105) showed no significant effect on the primary end point in patients with stable HF with reduced ejection fraction and predominantly CSA, but all-cause and cardiovascular mortality were both increased in the ASV arm. These results are surprising and inconsistent with earlier smaller studies reporting positive surrogate outcomes, and they require additional study and resolution. However, until this is done, there is an urgent educational need for review of the approved labeling and validated clinical use of ASV within the medical community. The purpose of this educational activity is to review the appropriate use of ASV for the treatment of sleep-disordered breathing, including Cheyne-Stokes respiration, treatment-emergent central apnea, and opioid-induced periodic breathing. Emphasis will be placed on proper patient and therapy selection, especially in patients with HF.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Somers, Virend UNSPECIFIED UNSPECIFIED UNSPECIFIED Arzt, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Bradley, T. Douglas UNSPECIFIED UNSPECIFIED UNSPECIFIED Randerath, Winfried UNSPECIFIED UNSPECIFIED UNSPECIFIED Tamisier, Renaud UNSPECIFIED orcid.org/0000-0003-1128-6529 UNSPECIFIED Won, Christine UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-185099
DOI:	10.1016/j.chest.2018.03.052
Journal or Publication Title:	Chest
Volume:	153
Number:	6
Page Range:	S. 1501 - 1503
Date:	2018
Publisher:	ELSEVIER SCIENCE BV
Place of Publication:	AMSTERDAM
ISSN:	0012-3692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Critical Care Medicine; Respiratory System Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18509