YE Huan,SHAO Meiqin,SHI Xiaohong, et al. The efficacy of BiPAP and Auto-CPAP in patients with severe OSAHS accompanied with mild-to-moderate COPD[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2017, 47(5): 342-346.
Abstract：Objective: To investigate the efficacy and safety of bi-level positive airway pressure (BiPAP) and automatic pressure model of continuous positive airway pressure (Auto-CPAP) ventilation in the treatment of elderly patients with severe obstructive sleep apnea hypopnea syndrome (OSAHS) accompanied with mild-to-moderate chronic obstructive pulmonary disease (COPD). Methods: According to the random number table, 40 elderly patients with severe OSAHS accompanied with mild-to-moderate COPD were randomly divided into BiPAP group and Auto-CPAP group (n=20, each). The parameters were monitored at the 7th day, 30th day, 90th day and 180th day, which included apnea hypopnea index (AHI), the mean pulse oxygen saturation (M-SpO2), the lowest pulse oxygen saturation (L-SpO2), blood gas analysis (pH, PaCO2, PaO2), the changes of pulmonary function (FEV1/FVC, FEV1%), the mean effective pressure required for ventilation treatment, the ventilator average time nightly, Epworth sleepiness scale (ESS), COPD assessment test (CAT), and the hospitalization rate of acute COPD in 180 days were recorded. Results: At the 7th day, 30th day, 90th day and 180th day after treatment, AHI, M-SpO2, L-SpO2, pH, PaCO2, PaO2, FEV1/FVC, FEV1%, ESS and CAT all had no significant differences between BiPAP and Auto-CPAP group (P>0.05). The effective pressure required for ventilation treatment in Auto-CPAP group was less than that in BiPAP group, and the ventilator average time nightly in Auto-CPAP group was more than that in BiPAP group (P<0.05). The hospitalization rate of acute COPD in 180 days showed no significant difference between these two groups (P>0.05). The parameters such as AHI, PaCO2, ESS and CAT at the 7th day, 30th day, 90th day and 180th day were all lower than those before therapy, and the parameters such as PaO2, M-SpO2 and L-SpO2 at the 7th day, 30th day, 90th day and 180th day were all higher than those before therapy in these two groups (P<0.05). FEV1/FVC, FEV1% were slightly higher than those before treatment, but there was no significant difference (P>0.05). pH showed no significant difference before and after treatment (P>0.05). Obvious adverse reaction, such as skin bruised, abdominal distension and pneumothorax didn’t happen in all cases. Conclusion: There is no significant difference between BiPAP and Auto-CPAP in efficacy and safety, but patients’ compliance to Auto-CPAP is better than that to BiPAP. Furthermore, Auto-CPAP may be a better choice for patients with poor economic conditions who suffered from severe OSAHS accompanied with mild-to- moderate COPD because Auto-CPAP requires lower pressure.
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