Noninvasive Ventilation
SLEEP MEDICINE CLINICS (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - October 30, 2020 Category: Sleep Medicine Authors: Lisa F. Wolfe, Amen Sergew Source Type: research
Copyright
ELSEVIER (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - October 30, 2020 Category: Sleep Medicine Source Type: research
Sleep Medicine Clinics
Unravelling the Puzzle of Adherence in Sleep Medicine (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - October 30, 2020 Category: Sleep Medicine Source Type: research
Contributors
TEOFILO LEE-CHIONG, Jr, MD (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - October 30, 2020 Category: Sleep Medicine Source Type: research
Contents
Lisa F. Wolfe and Amen Sergew (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - October 30, 2020 Category: Sleep Medicine Source Type: research
Noninvasive Ventilation and Spinal Cord Injury
Individuals with spinal cord injury (SCI) are at increased risk of respiratory complications during wake and sleep. Sleep-disordered breathing (SDB) is commonly associated with SCI and requires an individualized approach to its management. Respiratory control plays a key role in the pathogenesis of SDB in cervical SCI. Noninvasive ventilation plays an important role in the management of respiratory complications in individuals with SCI acutely and in chronic phases. Positive airway pressure treatment may be effective in eliminating SDB and improving sleepiness symptoms, but adherence to treatment is poor and effect on long...
Source: Sleep Medicine Clinics - October 5, 2020 Category: Sleep Medicine Authors: Asil Daoud, Samran Haider, Abdulghani Sankari Source Type: research
Perioperative Care and Medication-related Hypoventilation
Cumulative evidence supports the association of adverse postoperative outcomes with obstructive sleep apnea (OSA) and obesity hypoventilation syndrome (OHS). Although current guidelines recommend preoperative screening for OSA and OHS, the best perioperative management pathways remain unknown. Interventions attempting to prevent complications in the postoperative period largely are consensus based and focused on enhanced monitoring, conservative measures, and specific OSA therapies, such as positive airway pressure. Until further research is available to improve the quality and strength of these recommendations, patients w...
Source: Sleep Medicine Clinics - October 5, 2020 Category: Sleep Medicine Authors: Kara Dupuy-McCauley, Bernardo Selim Source Type: research
Tailoring the Sleep Laboratory for Chronic Respiratory Failure
“Many seemingly mundane aspects of the sleep laboratory can have outsized effects on the quality of polysomnographic data obtained from, and care provided to, patients. This is particularly true when performing polysomnography on patients with chronic respiratory failure due to various causes. Thi s article uses a disease-based approach to review physical and protocol-based accommodations that should be considered when performing polysomnography on this patient population.” (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - October 5, 2020 Category: Sleep Medicine Authors: Justin A. Fiala, John M. Coleman Source Type: research
Extubating to Noninvasive Ventilation
Weaning to noninvasive ventilation in intensive care unit and bridging the patients to home with respiratory support is evolving as the technology of noninvasive ventilation is improving. In patients with chronic obstructive pulmonary disease exacerbation, timing of initiation of noninvasive ventilation is the key, as persistently hypercapnic patients show benefits. High-intensity pressure support seems to do better in comparison to low-intensity pressure support. In patients with obesity and hypercapnia, obesity hypoventilation cannot be ruled out especially in an inpatient setting, and it is crucial that these patients a...
Source: Sleep Medicine Clinics - October 5, 2020 Category: Sleep Medicine Authors: Ashima S. Sahni, Lien-Khuong Tran, Lisa Wolfe Source Type: research
Noninvasive Ventilation Downloads and Monitoring
“Home noninvasive ventilation (NIV) is indicated for numerous conditions including neuromuscular disease, thoracic cage disorders, chronic obstructive pulmonary disease, and hypoventilation syndromes. Effective management of patients on home NIV requires clinicians to interpret data downloads from NIV devices. Clinicians must first look at adherence and factors that may impact this including mask comfort and fit. Next, leak assessment is undertaken. Once these are addressed, such information as apnea-hypopnea index, exhaled tidal volume, and percent triggered breaths help clinicians troubles hoot setting changes. Finally...
Source: Sleep Medicine Clinics - October 5, 2020 Category: Sleep Medicine Authors: Philip Choi, Veronique Adam, David Zielinski Source Type: research
Phrenic Nerve Involvement in Neuralgic Amyotrophy (Parsonage-Turner Syndrome)
Neuralgic amyotrophy is a poorly understood neuromuscular disorder affecting peripheral nerves mostly within the brachial plexus distribution but can also involve other sites including the phrenic nerve. In the classic form of the syndrome it causes proximal upper limb and neck pain on the affected side with subsequent muscle weakness that can be highly heterogeneous. Nocturnal noninvasive ventilation support is a first-line treatment after phrenic mononeuropathy. The regular monitoring of diaphragm function with spirometry and diaphragm ultrasound can help determine prognosis and inform decision-making. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - October 4, 2020 Category: Sleep Medicine Authors: Ellen Farr, Dom D ’Andrea, Colin K. Franz Source Type: research
Lifetime Care of Duchenne Muscular Dystrophy
Individuals with Duchenne muscular dystrophy (DMD) have evolving sleep and respiratory pathophysiology over their lifetimes. Across the lifespan of DMD, various sleep-related breathing disorders (SRBD) have been described, including obstructive sleep apnea, central sleep apnea, and nocturnal hypoventilation. In addition to SRBD, individuals with DMD can be affected by insomnia, chronic pain and other factors interfering with sleep quality, and daytime somnolence. The natural progression of DMD pathophysiology has changed with the introduction of therapies for downstream pathologic pathways and will continue to evolve with ...
Source: Sleep Medicine Clinics - October 4, 2020 Category: Sleep Medicine Authors: Erin W. MacKintosh, Maida L. Chen, Joshua O. Benditt Source Type: research
Management of Rare Causes of Pediatric Chronic Respiratory Failure
This article reviews pediatric-specific considerations of NiPPV therapy. Indications for NiPPV therapy can be categorized by the cause of the respiratory failure: (1) upper airway obstruction, (2) musculoskeletal and/or neuromuscular disease, (3) lower respiratory tract diseases, and (4) control of breathing abnormalities. The role of NiPPV therapy in select rare conditions (spinal muscular atrophy, congenital central hypoventilation syndrome, cerebral palsy, scoliosis, and Chiari malformations) is also reviewed. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - September 29, 2020 Category: Sleep Medicine Authors: Jenny Shi, Nawal Al-Shamli, Jackie Chiang, Reshma Amin Source Type: research
Obesity Hypoventilation
Obesity hypoventilation syndrome is the most frequent cause of chronic hypoventilation and is increasingly more common with rising obesity rates. It leads to considerable morbidity and mortality, particularly when not recognized and treated adequately. Long-term nocturnal noninvasive ventilation is the mainstay of treatment but evidence suggests that CPAP may be effective in stable patients. Specific perioperative management is required to reduce complications. Some unique syndromes associated with obesity and hypoventilation include rapid-onset obesity with hypoventilation, hypothalamic, autonomic dysregulation (ROHHAD), ...
Source: Sleep Medicine Clinics - September 24, 2020 Category: Sleep Medicine Authors: Roop Kaw, Marta Kaminska Source Type: research
Noninvasive Ventilator Devices and Modes
Noninvasive ventilation has become an increasingly common treatment strategy for patients with diverse conditions involving chronic respiratory failure. An intimate understanding of various advanced respiratory devices and modes is essential in the management of these patients. Pressure-limited modes of ventilation are more commonly used than volume modes for noninvasive ventilation owing to enhanced patient comfort and synchrony with the ventilator, as well as improved leak compensation. Common pressure modes include spontaneous/timed and pressure control, with volume-assured pressure support being an additive feature ava...
Source: Sleep Medicine Clinics - September 24, 2020 Category: Sleep Medicine Authors: Gaurav Singh, Michelle Cao Source Type: research
