September 2013
Register Now for AARC Congress 2013
The AARC Congress will head to Anaheim, CA, Nov. 16-19, and the agenda is packed with presentations that will be of special interest to respiratory therapists specializing in sleep. So take a few moments to review the program and then make your plans to attend. VIEW PROGRAM
New Surgical Option for OSA
OSA patients who cannot tolerate CPAP sometimes opt for uvulopalatopharyngoplasty. But the surgery is effective less than 50% of the time, in part because it only targets blockage at the soft palate level. A researcher from Wayne State University is improving those odds through the use of a new robotic device that’s already been found effective in removing cancerous tumors in the back of the throat. With the da Vinci Surgical System, he has been able to safely and precisely remove excessive tissue causing airway obstruction in areas that can’t be reached by traditional surgery. In a study involving 12 patients, 75% had significant improvements in the apnea-hypopnea index (AHI), and an overall improvement in the condition was seen in 25% as well, with some being better able to tolerate CPAP after the operation. The study appeared in the July edition of The Laryngoscope. READ PRESS RELEASE
Improving OSA Care in the Hospital
Many hospitals attempt to identify OSA patients through the use of hospital-based questionnaires, but these tools often fail to uncover all cases. Researchers from Intermountain Healthcare decided to use a large enterprise data warehouse capable of monitoring patient encounters over a wide geographical area to target patients with a previous diagnosis of OSA. The use of early computer alerts by respiratory therapists unveiled significantly more OSA patients, who were then prescribed appropriate medical care while in the hospital. This treatment resulted in fewer incidences of hypoxemia, with the greatest impact seen in patients undergoing surgery. The study appeared in a recent issue of Studies in Health Technology and Informatics. READ ABSTRACT
Respiratory and Auditory Cortical Processing Differs in Kids with OSAS
Researchers from the Children’s Hospital of Philadelphia who looked at the effects of respiratory and auditory cortical processing in children with OSAS find these children have persistent primary or irreversible respiratory afferent cortical processing deficits during sleep that could put them at risk of OSAS recurrence. However, the cortical processing of auditory afferent stimuli during sleep does not appear to be affected by OSA. The investigators reached those conclusions after testing 24 children with OSAS during N3 sleep, with 13 of the children retested 4-6 months following adenotonsillectomy. Results showed that respiratory-related evoked potentials were blunted in OSAS compared to controls and did not improve after OSAS treatment, while auditory evoked potentials were similar in OSAS and controls at baseline and did not change after treatment. The study was published ahead of print by the American Journal of Respiratory and Critical Care Medicine on Aug. 15. READ ABSTRACT
Servo-ventilation Outperforms NPPV in Complex Sleep Apnea
OSA patients who develop complex sleep apnea syndrome while being treated with CPAP may benefit more from servo-ventilation than noninvasive positive pressure ventilation (NPPV), report German researchers publishing in the Aug. 1 edition of Sleep. They randomized 30 patients with similar AHI, apnea indices, central apnea indices, and oxygen desaturation indices to either NPPV or servo-ventilation, then performed full polysomnography on the patients after six weeks of treatment. Initial titration of NPPV and servo-ventilation significantly improved all four measures when compared to CPAP, but servo-ventilation outperformed NPPV after six weeks of treatment. READ ABSTRACT
