Failure of adaptive servo-ventilation to correct central sleep disorder breathing in a patient with congestive heart failure
Abhijeet Singh, M. K. Sen, S. Chakrabarti
Central sleep apnea, Cheyne–Stokes breathing, adaptive servoventilation.
Citation Information :
Singh A, Sen MK, Chakrabarti S. Failure of adaptive servo-ventilation to correct central sleep disorder breathing in a patient with congestive heart failure. Indian Sleep Med 2014; 9 (4):186-189.
We report a patient with congestive heart failure secondary to dilated cardiomyopathy who demonstrated central sleep apnea with Cheyne–Stokes breathing (CSA-CSB) on polysomnography. He was put on positive airway pressure therapy with adaptive servoventilation (ASV), which failed to correct the CSA-CSB condition. A backup rate was added with ASV, which eliminated apnea but periodic breathing persisted. Finally, enhanced expiratory rebreathing spacewas added and titrated with ASV to achieve normocapniausing transcutaneous CO2 monitoring that successfully stabilized the patient's breathing.
Yumino D, Bradley DT. Central sleep apnea and Cheyne– Stokes respiration. Proc Am Thorac Soc.2008;5(2):226– 236.
Momomura S. Treatment of Cheyne–Stokes respirationcentral sleep apnea in patients with heart failure. J Cardiol.2012;59(2):110–116.
Eckert DJ, Jordan AS, Merchia P, Malhotra A. Central sleep apnea: pathophysiology and treatment. Chest. 2007;131(2):595–607.
Koyama T, Watanabe H, Tamura Y, Oguma Y, Kosaka T, Ito H. Adaptive servo-ventilation therapy improves cardiac sympathetic nerve activity in patients with heart failure. Eur J Heart Fail.2013;15(8):902–909.
Brown LK, Javaheri S. Adaptive servo-ventilation for the treatment of central sleep apnea in congestive heart failure: what have we learned?Curr OpinPulm Med.2014;20(6):550–557.
Reddy H, Dillard TA. A failure of adaptive servo-ventilation to correct central apneas in Cheyne-Stokes breathing. J Clin Sleep Med.2012;8(1):103–106.
Banno K, Okamura K, Kryger MH. Adaptive servoventilation in patients with idiopathic Cheyne-Stokes breathing. J Clin Sleep Med.2006;2(2):181–186.
Gilmartin G, McGeehan B, Vigneault K, et al. Treatment of positive airway pressure treatment-associated respiratory instability with enhanced expiratory rebreathing space (EERS). JClin Sleep Med.2010;6(6):529–538.