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London 2016
Tuesday, 06.09.2016
Treatment options for obstructive sleep apnoea and obesity hypoventilation
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Persistent daytime hypercapnia predicts poor prognosis in OSAS undergoing CPAP therapy
Naoko Kawata (Chiba, Japan), Naoko Kawata, Jiro Terada, Koichiro Tatsumi
Source:
International Congress 2016 – Treatment options for obstructive sleep apnoea and obesity hypoventilation
Session:
Treatment options for obstructive sleep apnoea and obesity hypoventilation
Session type:
Poster Discussion
Number:
3424
Disease area:
Sleep and breathing disorders
Abstract
Background:
Positive airway pressure therapy (PAP) is reported to improve the mortality of OSAS with daytime hypercapnia . However, the data on long-term prognosis in hypercapnic OSAS undergoing CPAP therapy are limited.
Objective:
Our study objectives were to investigate the survival and explore prognostic factors in OSAS with daytime hypercapnia undergoing CPAP therapy.
Methods:
Thirty-seven patients who were diagnosed OSAS with daytime hypercapnia (PaCO₂ > 45mmHg) were enrolled. All of them are treated with CPAP therapy. The patients were divided into 2 groups according to the improvement of PaCO₂ by CPAP therapy after 3 months (the change in PaCO₂
³
5mmHg; good responder, the change in PaCO₂ < 5mmHg; poor responder). Long-term mortality and predictors of survival were evaluated.
Results:
During median follow-up of 125 months, All-cause mortality was 33%, in poor responder group to CPAP therapy. In contrast, all of the patients in good responder group survived (log-lank, p = 0.0115). In univariate analysis, patients with PaO₂< mmHg and PaCO₂>45 mmHg at baseline had poor prognosis (p =0.0013, p <0.0001, respectively). In Cox multivariate analysis, PaCO₂ after CPAP therapy was independent predictor of mortality (p = 0.042). In contrast, neither BMI nor results of pulmonary function tests was linked to their survival.
Conclusion:
The presence of hypercapnia which is resistant to CPAP therapy predicts poor prognosis in hypercapnic OSAS.
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Citations should be made in the following way:
Naoko Kawata (Chiba, Japan), Naoko Kawata, Jiro Terada, Koichiro Tatsumi. Persistent daytime hypercapnia predicts poor prognosis in OSAS undergoing CPAP therapy. Eur Respir J 2016; 48: Suppl. 60, 3424
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