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Predictive equations for CPAP titration in OSAS patients

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Abstract

Background

Continuous positive airway pressure (CPAP) is the elective treatment of obstructive sleep apnea. The therapeutic level of CPAP is generally established by manual titration or an auto CPAP device, but an alternative way involves the use of predictive formulas. The aim of the present study was to test the difference between mathematical equations and CPAP or auto CPAP in terms of therapeutic pressure.

Methods

A retrospective analysis of 197 subjects with a diagnosis of obstructive sleep apnea needing a CPAP treatment was performed. The patients were divided into two groups: the first one included patients who had received CPAP after manual titration and the second one included patients who had received auto CPAP titration. The therapeutic CPAP pressure was then compared to the pressure calculated by three different equations: Eq. A by Stradling, Eq. B by Sériès, and Eq. C by Hoffstein.

Results

One hundred ninety-seven patients were included in the study, 110 were titrated by auto CPAP and 87 by manual titration. There was a positive correlation between the pressure defined by the three equations and both titration methods, but each equation usually gave a higher pressure with patients needing CPAP <8 and lower for patients needing CPAP >11. Equation C normally gave a lower result than the other two equations.

Conclusions

Manual or auto CPAP titration remains the best way to define the appropriate CPAP. However, predictive formulas can be useful if used with caution and always after verifying the real efficacy, particularly for patients needing higher pressure.

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Abbreviations

OSAS:

Obstructive sleep apnea syndrome

CPAP:

Continuous positive airway pressure

ACPAP:

Auto-continuous positive airway pressure

AHI:

Apnea hypopnea index

ODI:

Oxygen desaturation index

BMI:

Body mass index

NC:

Neck circumference

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Authors and Affiliations

  1. Institute of Respiratory Diseases, Department of Medical and Occupational Sciences, University of Foggia, Foggia, Italy

    Donato Lacedonia, Roberto Sabato, Giovanna E Carpagnano & Maria P Foschino Barbaro

  2. Institute of Pulmonary Disease, University of Bari, Bari, Italy

    Pierluigi Carratù, Antonio Falcone, Felice Gadaleta & Onofrio Resta

Authors
  1. Donato Lacedonia
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  2. Roberto Sabato
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  3. Giovanna E Carpagnano
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  4. Pierluigi Carratù
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  5. Antonio Falcone
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  6. Felice Gadaleta
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  7. Onofrio Resta
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  8. Maria P Foschino Barbaro
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Correspondence to Donato Lacedonia.

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All authors disclose any financial relationship with a biotechnology and/or pharmaceutical manufacturer that has an interest in the subject matter or materials discussed in this manuscript.

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Lacedonia, D., Sabato, R., Carpagnano, G.E. et al. Predictive equations for CPAP titration in OSAS patients. Sleep Breath 16, 95–100 (2012). https://doi.org/10.1007/s11325-010-0461-1

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  • DOI: https://doi.org/10.1007/s11325-010-0461-1

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