閉塞型睡眠時無呼吸症候群に対する自動圧調整CPAP装置を用いたnCPAP療法の治療圧設定(タイトレーション) Unattended Automated Titration to Determine Therapeutic Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnea

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検査技師が終夜監視を行わずにAuto CPAP装置のデータとPSGの解析値,マスク内圧波形,イベントを参考にしてnCPAP療法の治療圧を決定するtitration法をpreliminaryに検討した.<br>1. 本法を用いたtitrationにより,nCPAP療法の治療圧を設定でき,呼吸,睡眠構築とも改善できた.<br>2. nCPAP療法の設定圧はAuto CPAP装置の95パーセンタイル圧を川いた方が良いことが示唆された.<br>3. Auto CPAP装置によりnCPAP療法のtitrationを行う際には,PSGを同時に行いながら効果を判定する必要があると考えられた.<br>4. 設定した治療圧が適切かどうか、患者自身のnCPAP装置を装着してPSGを行い,効果を判定する必要があると考えられた.<br>5. マンパワーが不足している施設では,本法はUnattrnded titration の一つの方法といえた.

Recently, devices which use a new technology that automatically titrates positive airway pressure have become available. Such devices continually adjust the pressure to maintain airway patency. In this paper, unattended automated titration to determine the therapeutic continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea was evaluated to ascertain of it was a feasible titration to determine the therapeutic CPAP.<br>Thirty patients participated in this study with obstructive sleep apnea syndrome defined by an apnea hypopnea index >20/h. Automated titration during full polysomnography was performed in the hospital using auto CPAP devices (Autoset T. RESMED Co. Australia). During titration, there was no direct supervision by a technician. The titration method was as follows. Data obtained during the use of auto CPAP devices and polysomnography were used to provide a fixed<br>single pressure for subsequent treatment. After determining the therapeutic continuous positive airway pressure, the efficacy of the patient's CPAP device was reconfirmed during full polysomnography.<br>The results were, 1) Proper fixed single therapeutic pressure could be determined with this unattended automated titration, consequently apnea and sleep structure could be improved (Total sleep time, Sleep efficiency, %Stage 3+4, Apnea index, Apnea hypopnea index, Arousal index, Lowest SpO<sub>2</sub>, and Duration of SpO<sub>2</sub> less than 90% were improved statistically (p<0.05)). 2) The 95<sup>th</sup> percentile airway pressure of the auto CPAP device should be applied for the therapeutic pressure. 3) Automated titration during full polysomnography should be performed using auto CPAP devices. 4) After determining the therapeutic CPAP, the efficacy of the patient's CPAI' device should be reconfirmed during full polysomnography. 5) This method of titration was useful at the institution without attendant technician intervention.

収録刊行物

  • 日本耳鼻咽喉科學會會報

    日本耳鼻咽喉科學會會報 107(5), 494-499, 2004-05-20

    The Oto-Rhino-Laryngological Society of Japan, Inc.

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各種コード

  • NII論文ID(NAID)
    10013133444
  • NII書誌ID(NCID)
    AN00191551
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    00306622
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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