Browse > Article
http://dx.doi.org/10.15324/kjcls.2020.52.3.278

Case of Treatment Using Adaptive Servo-Ventilation in a Patient with Central Sleep Apnea after a Lateral Medullary Infarction  

Kim, Dae Jin (Department of Neurology, Pusan National University Yangsan Hospital)
Cho, Jae Wook (Department of Neurology, Pusan National University Yangsan Hospital)
Kim, Hyun Woo (Department of Neurology, Pusan National University Yangsan Hospital)
Choi, Jeong Su (Department of Health and Safety Convergence Science, Graduate School, Korea University)
Mun, Sue Jean (Department of Otorhinolaryngology-Head & Neck Surgery, Pusan National University Yangsan Hospital)
Publication Information
Korean Journal of Clinical Laboratory Science / v.52, no.3, 2020 , pp. 278-283 More about this Journal
Abstract
Central sleep apnea (CSA) is characterized by respiratory failure of at least 10 seconds without any effort of the chest and abdomen in the absence of upper airway resistance during sleep. In this case, the patient experiences respiratory failure that does not meet the CSA diagnostic criteria and CSA symptoms. Magnetic resonance imaging diffusion-weighted imaging (MRI DWI) scans revealed a lateral medullary infarction. Continuous positive airway pressure (CPAP) was applied as a primary treatment for CSA and respiratory failure. During the titration of CPAP, the apnea-hypopnea index (AHI) and arousal index (AI) were worse than the results before its use (AHI: 42.5/hr→82.8/hr, AI: 21.7/hr→40.8h). As a result, adaptive servo-ventilation (ASV) was chosen as the secondary treatment. Compared to the night-polysomnography results before the ASV treatment, the AHI improved (42.5/hr→8.6/hr). Therefore, ASV is a potential treatment for CSA and respiratory failure in these patients.
Keywords
Adaptive servo ventilation; Central sleep apnea; Continuous positive airway pressure;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Oates CP, Ananthram M, Gottlieb SS. Management of sleep disordered breathing in patients with heart Failure. Curr Heart Fail Rep. 2018;15:123-130. https://doi.org/10.1007/s11897-018-0387-7   DOI
2 Correa D, Famey RJ, Chung F, Prasad A, Lam D, Wong J. Chronic opioid use and central sleep apnea: a review of the prevalence, mechanisms, and perioperative considerations. Anesth Analq. 2015;120:1273-1285. https://doi.org/10.1213/ANE.0000000000000672   DOI
3 Chowdhuri S, Badr MS. Central sleep apnoea. Indian J Med Res. 2010;131:150-164.
4 Nannapaneni R, Behari S, Todd NV, Mendelow AD. Retracing "Ondine's Curse". Neurosurgery. 2005;57:354-363. https://doi.org/10.1227/01.NEU.0000166684.69422.49   DOI
5 Aurora RN, Bista SR, Casey KR, Chowdhuri S, Kristo DA, Mallea JM, et al. The treatment of central sleep apnea syndromes in Adults: practice parameters with an evidence-based literature review and meta-analsis. SLEEP. 2012;35:17-40. https://doi.org/10.5665/sleep.1580.   DOI
6 Hetzenecker A, Roth T, Bimer C, Maier LS, Pfeifer M, Arzt M. Adaptive servo-ventilation therapy of central sleep apnoea and its effect on sleep quality. Clin Res Cardiol. 2016:105;189-195. https://doi.org/10.1007/s00392-015-0904-6   DOI
7 Tanaka K, Kanamaru H, Morikawa A, Kawaguchi K. Central Hypoventilation syndrome complicated with lateral medullary infarction after endovascular treatment of the vertebral artery dissection aneurysm: a case report. NMC Case Rep J. 2016:3;133-136. http://doi.org/10.2176/nmccrj.cr.2016-0067   DOI
8 Mun SJ, Cho KS. Modalities and indication of positive airway pressure in sleep apnea. J Clinical Otolaryngol. 2019:30;25-31. https://doi.org/10.35420/jcohns.2019.30.1.25
9 Severinghaus JW, Mitchell RA. Ondine's curse failure of respiratory center automaticity while awake. Clin Res. 1962:10;122
10 Dohi T, Kasai T, Narui K, Ishiwata S, Ohno M, Yamaguchi T, Monomura SI. Bi-level positive airway pressure ventilation for treating heart failure with central sleep apnea that is unresponsive to continuous positive airway pressure. Cir J. 2008:32;91-98. https://doi.org/10.1253/circj.72.1100
11 Heider K, Arzt M, Lerzer C, Kolb L, Pfeifer M, Maier LS, et al. Adaptive servo-ventilation and sleep quality in treatment emergent central sleep apnea and central sleep apnea in patients with heart disease and preserved ejection fraction. Clin Res Cardiol. 2018:107;421-429. https://doi.org/10.1007/s00392-018-1203-9   DOI