Overlap Syndrome Clinical Trial
Official title:
Effect of Auto-Trilevel Ventilation on Patients With Overlap Syndrome
Obstructive Sleep Apnea Syndrome (OSAS) and chronic obstructive pulmonary disease (COPD) are
two diseases that often coexist and are called overlap syndrome(OS). Compared to single
OSAS, OS patients are more susceptible to serious hypoxia and hypercapnia especially during
sleep, and are much more likely to result in pulmonary hypertension and cor-pulmonal.
With a more flexible expiratory positive airway pressure (EPAP), auto-trilevel ventilation
may be superior to fixed bilevel positive airway pressure (BiPAP) ventilation in both
removing residual obstructive sleep apnea hypopnea events and correcting hypercapnia
simultaneously. The overall purpose of this study is to compare the curative effects between
fixed BiPAP and auto-trilevel ventilations on OS patients.
The contradiction in treatment for overlap syndrome is how to improve hypercapnia because of
narrower difference between inspiratory positive airway pressure (IPAP) and expiratory
positive airway pressure (EPAP), and meanwhile to eliminate apnea and popnea events which
may easily occur at the end of expiration For ordinary Bipap ventilator. If the IPAP is set
to higher, the patients may feel discomfort, if the pressure difference between IPAP and
EPAP is too narrow or the expiratory positive airway pressure (EPAP) too high, hypercapnia
may occur. If the EPAP is too low, redusual apnea and hypopnea event may become common.
Auto-trilevel ventilation, with a lower airway pressure at the beginning of expiration to
prevent hypercapnia and a higher airway pressure at the end of expiration to prevent
residual apnea events, should be able to provide a novel ventilation mode with a higher
efficacy and lower average airway pressure for overlap syndrome. To prove the hypothesis,
comparison is made between ordinary BiPAP and auto-Trilevel ventilation modes during
treatment for patients with overlap syndrome.
In this study, the investigators compare the changes of related indexes including apnea
hypopnea indexăminimal pulse oxygen saturationăarousal index, sleep quality,PaCO2 and
sleepiness scores) before and on treatment. Meanwhile, curative effects will be compared
between BiPAP and auto-Trilevel ventilation modes. The investigators will analyze the
changes and then confirm our hypothesis.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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