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adaptive servo-ventilation (ASV)

Indications: - Cheyne-Stokes respirations in patients with heart failure [2,4] - may be useful in patients with central sleep apnea [6] Contraindications: - not useful in patients with central sleep apnea & heart failure due to LV systolic dysfunction [1]* - contraindicated in patients with LVEF < 45% [7] * ref [5] reports that adaptive servo-ventilation is effective in patients with systolic heart failure without mention of Cheyne-Stokes respirations Procedure: - uses a noninvasive ventilator by delivering servo-controlled inspiratory pressure support on top of expiratory positive airway pressure [1]

General

non-invasive positive pressure ventilation (NPPV)

References

  1. Cowie MR et al Adaptive Servo-Ventilation for Central Sleep Apnea in Systolic Heart Failure. N Engl J Med. Sept 1, 2015 PMID: 26323938 http://www.nejm.org/doi/full/10.1056/NEJMoa1506459 - Magalang UJ, Pack AI Heart Failure and Sleep-Disordered Breathing - The Plot Thickens. N Engl J Med. Sept 1, 2015 PMID: 26323939 http://www.nejm.org/doi/full/10.1056/NEJMe1510397
  2. Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
  3. Miyata M, Yoshihisa A, Suzuki S et al Adaptive servo ventilation improves Cheyne-Stokes respiration, cardiac function, and prognosis in chronic heart failure patients with cardiac resynchronization therapy. J Cardiol. 2012 Sep;60(3):222-7. PMID: 22727431 Free Article
  4. Morgenthaler TI, Gay PC, Gordon N, Brown LK. Adaptive servoventilation versus noninvasive positive pressure ventilation for central, mixed, and complex sleep apnea syndromes. Sleep. 2007 Apr;30(4):468-75. PMID: 17520791
  5. Takama N, Kurabayashi M. Safety and efficacy of adaptive servo-ventilation in patients with severe systolic heart failure. J Cardiol. 2014 Apr;63(4):302-7. PMID: 24373869 Free Article
  6. Medical Knowledge Self Assessment Program (MKSAP) 17, 18 American College of Physicians, Philadelphia 2015, 2018
  7. Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019