Patient education and motivational enhancement can make the difference between adherence and non-use of positive airway pressure

2014 ◽  
pp. 111-114
Author(s):  
Deirdre A. Conroy ◽  
Jennifer R. Goldschmied
Keyword(s):  
Patient Education ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Motivational Enhancement ◽  
The Difference

scholarly journals Effects of nasal continuous positive airway pressure on cerebral hemodynamics in preterm infants

2019 ◽  
Author(s):  
Han ZHOU ◽  
Youyan ZHAO ◽  
Rui CHENG ◽  
Xuewen HOU ◽  
Jie Qiu
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Preterm Infants ◽  
Airway Pressure ◽  
Near Infrared ◽  
Cerebral Blood Volume ◽  
Positive Airway Pressure ◽  
Oxygenation Index ◽  
Cerebral Hemodynamics ◽  
Peripheral Oxygen Saturation ◽  
The Difference

Abstract Background To evaluate effects of different positive end-expiratory pressure (PEEP) levels on cerebral hemodynamics of premature infants when using nasal continuous positive airway pressure (nCPAP) during the first 3 days of life. Methods Forty-four preterm infants treated with nCPAP were divided into very preterm infant group (gestational age 1 (GA1) group, GA<32 weeks, n=24) and moderate and late preterm group (GA2 group, GA 32-37 weeks, n=20). During the monitoring process, the PEEP was set at 4→6→8→4 cmH 2 O and cerebral hemodynamics was assessed by near-infrared spectroscopy (NIRS). Life signs, peripheral oxygen saturation (SpO 2 ) and transcutaneous carbon dioxide pressure (TcPCO 2 ) were recorded at the same time. Results Tissue oxygenation index (TOI), cerebral blood volume (△CBV) and the difference between oxygenated hemoglobin (△HbO 2 ) and deoxygenated hemoglobin (△HHb) (△HbD) were all significantly positive correlated with gestational and postnatal age and the fluctuation of GA1 group was greater. △CBV and △HbD were also significantly positive correlated with TcPCO 2 . PEEP of 4-8 cmH 2 O had no significant influence on cerebral hemodynamics, life signs, SpO 2 or TcPCO 2 . Conclusions No significant differences were observed in cerebral hemodynamics when the PEEP was set from 4 to 8 cmH 2 O. These findings confirmed the safety and reliability of nCPAP at regular pressure levels to the nervous system of preterm infants.

Effect of Positive Airway Pressure During Preoxygenation on Safe Apnea Period: a comparison of the supine and 25° head up position

2020 ◽  
Vol 18 (2) ◽  
pp. 62-67
Author(s):  
Y. Dhakal ◽  
B. Bhattarai ◽  
S. Khatiwada ◽  
A. Subedi
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Supine Position ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Conventional Technique ◽  
Head Up Tilt ◽  
The Difference ◽  
Post Intubation ◽  
Induction Of Anaesthesia ◽  
Safe Apnea Period

Background Preoxygenation is performed before induction of anaesthesia which increases oxygen reserve and provides delayed onset of hypoxia during period of apnea. Several techniques such as positive airway pressure and head-up tilt during preoxygenation have shown to prolong safe apnea period compared to conventional technique. However, uniform recommendations have not yet been made. Objective To find out the effect of combination of 5 cmH2O continuous positive airway pressure (CPAP) and 25° head up position during preoxygenation on safe apnea period. Method In this comparative study 60 non-obese adult patients were divided into three equal groups; Group C receiving preoxygenation in conventional technique, Group S receiving preoxygenation with 5 cmH2O continuous positive airway pressure in supine position and Group H receiving preoxygenation in 25° head-up position with 5 cmH2O continuous positive airway pressure . After 3 min of preoxygenation, intubation was performed after induction of anaesthesia with propofol, fentanyl and succinylcholine. After confirming the tracheal intubation by direct visualization, all patients were administered vecuronium to maintain neuromuscular blockade. Post-intubation, patients in all groups were left in same position with the tracheal tube exposed to atmosphere and without being ventilated till the SpO2 dropped to 92%. The primary outcome compared between the groups was the safe apnea period (time from loss of consciousness to fall of SpO2 to 92%). Result The duration of safe apnea period was longer (p < 0.05) in Group H patients (405.9 ± 106.69 s) as compared to the Group C (296.9 ± 99.01s) and Group S (319.65 ± 71.54s). Although the duration of safe apnea period was longer in the Group S as compared to Group C the difference was not statistically significant. Conclusion Preoxygenation in 25° head-up position with 5 cmH2O continuous positive airway pressure significantly prolongs safe apnea period in non-obese adults compared to supine position, with or without 5 cmH2O continuous positive airway pressure.

Effectiveness of preoxygenation with positive airway pressure in non-obese healthy patient: a comparison of the supine and 25° head up position

2019 ◽  
Author(s):  
Yogesh Dhakal ◽  
Balkrishna Bhattarai ◽  
Sindhu Khatiwada ◽  
Asish Subedi
Keyword(s):  
Supine Position ◽  
Airway Pressure ◽  
Primary Outcome ◽  
Positive Airway Pressure ◽  
Controlled Trial ◽  
Conventional Technique ◽  
Randomized Controlled ◽  
Head Up Tilt ◽  
The Difference ◽  
Made In

Abstract Background Though conventional preoxygenation provides extended safe apnoeic period during endotracheal intubation, it is associated with atelectasis of lungs immediately after induction. Therefore, alternatives such as positive airway pressure and head-up tilt during preoxygenation have been explored but uniform recommendations have not yet been made. In the present study we aimed to find out the effect of combination of 5 cmH2O CPAP and 25° head up position during preoxygenation on non-hypoxic apnea period. Methods In this randomized controlled trial, 60 non-obese healthy adult patients were randomly divided into three groups; Group C receiving preoxygenation in conventional technique, Group S receiving preoxygenation in supine position with 5 cmH2O CPAP and Group H receiving preoxygenation in 25° head-up position with 5 cmH2O CPAP. After 3 min of preoxygenation, anesthesia was induced and trachea intubated. After confirming the tracheal intubation by direct visualization, all patients were administered vecuronium to maintain neuromuscular blockade and midazolam to prevent awareness. Post-induction, patients in all groups were left apneic in supine position with the tracheal tube exposed to atmosphere till the SpO2 dropped to 92%. The primary outcome compared between the groups was the non-hypoxic apnoeic period (time to fall SpO2 to 92%). Results The duration of non-hypoxic apnea period was longer (p<0.05) in Group H patients (405.90±106.69 s) as compared to the Group C (296.90±99.01 s) and Group S (319.65±71.54 s). Although the duration of non-hypoxic apnea was clinically longer in the Group S as compared to Group C the difference was not statistically significant. There were no remarkable adverse events observed in any group. Conclusion Preoxygenation in 25° head-up position with 5 cmH2O CPAP significantly prolongs non-hypoxic apnea period in non-obese healthy adults compared to supine position, with or without 5 cmH2O CPAP.

scholarly journals Ventilator-CPAP with the Siemens Servo 900C Compared with Continuous Flow-CPAP in Intubated Patients: Effect on Work of Breathing

1997 ◽  
Vol 25 (5) ◽  
pp. 487-492 ◽  
Author(s):  
J. G. J. V. Aerts ◽  
B. Van Den Berg ◽  
J. M. Bogaard
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Continuous Flow ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Flow System ◽  
Work Of Breathing ◽  
Expiratory Valve ◽  
Work Related ◽  
Additional Work ◽  
The Difference

The effects of continuous positive airway pressure (CPAP) provided by the Siemens Servo 900C ventilator were compared with a continuous flow system (CF-CPAP) in patients weaning from the ventilator. Thirteen patients were studied using both systems at a CPAP level of 0.5 kPa. Additional work of breathing (Wapp) and derived variables were determined in relation to the minute volumes of the patients. The Wapp imposed by the ventilator exceeded the Wapp of CF-CPAP in all patients. The difference in Wapp between ventilator- and CF-CPAP was greater at higher ventilatory needs. The increments in Wapp imposed by the ventilator were positively correlated with the actual end-expiratory pressures (EEP). The EEP increasingly exceeded the preset CPAP level of the ventilator at higher minute volumes. An inspiratory threshold due to a gradient between EEP and preset CPAP greatly increased the Wapp imposed by the ventilator. As this threshold was attributed to the resistance of the PEEP device of the ventilator, it indicates that the additional work related to the expiratory valve should be taken into account when the Siemens Servo 900C ventilator is used for weaning purposes.

scholarly journals Impact of Patient Education on Compliance with Positive Airway Pressure Treatment in Obstructive Sleep Apnea

2017 ◽  
Vol 23 ◽  
pp. 1792-1799 ◽  
Author(s):  
Sema Saraç ◽  
Gülgün Çetintaş Afşar ◽  
Özlem Oruç ◽  
Özgür Bilgin Topçuoğlu ◽  
Cüneyt Saltürk ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Patient Education ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Pressure Treatment ◽  
Obstructive Sleep

Effect of continuous positive airway pressure therapy in patients with paroxysmal atrial fibrillation and obstructive sleep apnea: a randomized controlled trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
G.M Traaen ◽  
L Aakeroy ◽  
T.E Hunt ◽  
B Overland ◽  
C Bendz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Usual Care ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Controlled Trial ◽  
Funding Source ◽  
Randomized Controlled ◽  
Effect Of Treatment ◽  
The Difference

Abstract Background There is strong evidence for an association between atrial fibrillation (AF) and sleep apnea (SA). Purpose We aimed to examine the effect of treatment with continuous positive airway pressure (CPAP) on the burden of AF. Methods After a run-in period for CPAP-tolerance, we randomly assigned 108 eligible patients between 18–75 years, who had paroxysmal AF and moderate-to-severe obstructive SA (apnea-hypopnea index (AHI)≥15), to receive either CPAP treatment (n=54) plus usual care or usual care alone (n=54) for five months. An implanted loop recorder measured time in AF continuously. The primary endpoint was the difference in change of AF burden (% of time in AF) between CPAP treatment and usual care from baseline (one month prior to randomization) to the last three months of the intervention period. Secondary endpoints were changes in quality of life assessed by the Short Form-36 (SF-36), Epworth Sleepiness Scale (ESS), and the Functional Outcomes of Sleep Questionnaire (FOSQ). Results Mean (SD) age was 62.4 (7.7) years, BMI 29.4 (4.2) kg/m2, ESS 7.9 (3.2), and 76.1% were men. In the intervention group, the mean duration of adherence to CPAP therapy was 4.3 hours/night. During treatment mean AHI decreased from 27.6 events/hour at baseline to 2.3 events/hour during follow-up. Mean time in AF decreased from 5.0%-4.3% in the control group and from 5.6%-4.1% in the CPAP group, but the difference in change was not significant (p=0.52). Sub-analysis of those using CPAP&gt;&lt;4 hours/night also showed no difference, neither did the quality of life questionnaires. Conclusion This is the first randomized controlled trial to assess the effect of treatment of SA on the burden of AF, and did not detect a difference between those treated with CPAP compared to usual care alone. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Oslo University Hospital is the main funding Source. ResMed Science Center provided an unrestricted grant.

Evaluating the effectiveness of patient education and the feasibility of health technology (eHealth interventions) in improving sleep quality and blood pressure secondary to greater adherence to continuous positive airway pressure ventilation in persons with obstructive sleep apnoea: A literature review (Preprint)

2021 ◽  
Author(s):  
Rabie Adel Abdel-Kar El Arab
Keyword(s):  
Blood Pressure ◽  
Continuous Positive Airway Pressure ◽  
Patient Education ◽  
Sleep Quality ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Sleep Apnoea ◽  
Cpap Adherence ◽  
Obstructive Sleep ◽  
Positive Airway Pressure Ventilation

UNSTRUCTURED Obstructive sleep apnoea is a highly burdensome condition that predominantly affects adults and not only impairs daily functioning but also confers a heightened risk of adverse cardiovascular health, particularly among those who are poorly compliant with continuous positive airway pressure ventilation therapy. In the growing era of high population demand and rising complexity, greater efforts are needed at the individual level if outcomes are to improve in the future. Therefore, this literature review sought to explore the effect of patient education upon sleep quality and blood pressure as secondary effects of CPAP adherence in adults. A search for relevant literature was performed using MEDLINE, EMBASE and the Cochrane library. Articles were restricted to peer-review, English language and publication in the last 10 years. Articles were appraised using CASP, relevant data was extracted using systematic proformas and the outcomes were analysed using descriptive analysis and narrative synthesis. Nine studies were included in the first analysis where there was a highly significant association between education provision and CPAP adherence (MD=1.19 hours/night, Z=3.67, p=0.0002), than compared to usual care. The second analysis was informed from five studies and this showed a positive association between education and sleep quality, but the effect was marginally insignificant (MD=0.54, Z=1.89, p=0.06), than compared to usual care. Both analyses were not affected by inter-study heterogeneity (both p<0.01). Overall, this review showed that the provision of education with moderate to high intensity provides meaningful effects upon CPAP adherence and sleep quality. Narrative findings also revealed improvements in blood pressure and other health outcomes, which are supported by previous studies. Despite some limitations, care providers should be proactivity in education provision using a continuous approach through the disease course as this is likely to lead to improvements in outcomes. Finally, future research is needed in the form of a high-quality randomised trial to help explore the effects of education delivered through eHealth mediums.

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