Home-Based Care Evolution in Chronic Respiratory Failure between 2001 and 2015 (Antadir Federation Observatory).

Background: The aetiologies of chronic respiratory failure (CRF) are moving in many western countries. Obesity-Hypoventilation syndrome (OHS) has become one of the most common indications of non-invasive ventilation (NIV) with Chronic Obstructive Pulmonary Diseases (COPD). Long-Term Oxygen Therapy (LTOT) technology is the treatment plan for CRF patients in the new era.

Survival of patients with chronic respiratory failure on long-term oxygen therapy and or non-invasive ventilation at home.

Background & Aims: Chronic respiratory failure (CRF) is the common fate of respiratory diseases where systemic effects contribute to outcomes. In a prospective cohort of home-treated patients with CRF, we looked for predictors of long-term survival including respiratory, nutritional and inflammatory dimensions.

Methods: 637 stable outpatients with CRF, 397 men, 68 ± 11 years, on long-term oxygen therapy and/or non-invasive ventilation from 21 chest clinics were enrolled and followed over 53 ± 31 months.

[Assessment of recent weight history before instituting continuous positive airways pressure in a cohort of patients with severe obstructive sleep apnoea/hypopnea syndrome].

Objectives: The aim of this study is to evaluate the recent weight history in patients with the obstructive sleep apnoea/hypopnoea syndrome (OSAHS) needing treatment with continuous positive airways pressure (CPAP).

Patients And Methods: Over a period of 18 months, a self-administered questionnaire concerning recent weight history was given to patients during the installation of CPAP.

Results: The study population consisted of 1337 patients.

Impact of sleep apnea on economics.

Obstructive sleep apnea syndrome (OSA) alters sleep quality and is associated with sleepiness and decreased cognitive functioning. It has therefore always been recognized as a major public health issue with potential societal consequences: accidents, increased morbidity, and cognitive deficits impairing work efficiency. The number of patients diagnosed and treated for OSA has increased drastically in the last few years.

Cardiovascular risk factors in men and women with obstructive sleep apnoea syndrome.

Unlabelled: We wished to evaluate the prevalence of cardiovascular (CV) risk factors in patients with obstructive sleep apnoea syndrome (OSAS) before initiation of continuous positive airway pressure (CPAP), and without any declared or diagnosed pre-existing CV disorder. We wanted to compare the prevalence of these CV risk factors between men and women in an observational study. A questionnaire concerning CV risk factors was submitted to the patients, by a respiratory home-care technician at the time of installation of the CPAP treatment.

Prevalence and predictive factors of sleep apnoea syndrome in type 2 diabetic patients.

Aim: This study aimed to assess the prevalence and characteristics of sleep apnoea syndrome (SAS) in patients hospitalized for poorly controlled type 2 diabetes.

Methods: An overnight ventilatory polygraphic study was systematically performed in 303 consecutive patients.

Results: Overall, 34% of these patients had mild SAS, as defined by a respiratory disturbance index (RDI) of 5-15; 19% had moderate SAS (RDI: 16-29) and 10% had severe SAS (RDI>or=30).

[Nonrespiratory sleep disorders in obese and diabetic patients].

Pneumologists frequently see obese and diabetic patients because of the high prevalence of these pathologies associated with sleep apneas. Nevertheless, the search for a sleep apnea syndrome is sometimes negative and the pneumologist is faced with unexplained complaints of sleepiness and sleep disorders. Pneumologists have to be familiar with and explore other nonrespiratory disorders in order to improve patient care.

Structural and functional arterial properties in patients with obstructive sleep apnoea syndrome and cardiovascular comorbidities.

The increased severity of obstructive sleep apnoea syndrome (OSAS) is associated with a parallel increase in the incidence of cardiovascular events. Whether the increased severity of OSAS is in fact associated with impaired arterial properties has never been thoroughly studied. In patients with OSAS who carry a high burden of cardiovascular risk factors, we investigated whether the severity of OSAS is associated with deterioration in the arterial properties, independent of classical cardiovascular risk factors.

[Metabolic and cardiovascular comorbidities and sleep disorders].

Several basic research studies have recently demonstrated the impact of sleep disorders in the occurrence or development of increasing diseases such as obesity, diabetes or hypertension. More recently epidemiological surveys seem to confirm this link. These studies have observed that a total sleep time under 6 hours was associated with an increased BMI, and a higher occurrence of diabetes and hypertension.

Efficacy and compliance of mandibular repositioning device in obstructive sleep apnea syndrome under a patient-driven protocol of care.

Objective: To assess the efficacy and compliance of a traction-based mandibular repositioning device (MRD) for treatment of moderate to severe obstructive sleep apnea syndrome (OSAS) under a patient-driven protocol in a routine outpatient care setting.

Methods: Forty patients, 10 severe and 30 moderate OSAS sufferers (apnea-hypopnea index [AHI] >30 and between 15 and 30, respectively), were enrolled by four sleep centers. Nocturnal polygraphy, quality of life, and quality of sleep questionnaires were used to measure the effect of treatment after 45 days.

Serum amyloid A and obstructive sleep apnea syndrome before and after surgically-induced weight loss in morbidly obese subjects.

Background: Serum amyloid A (SAA) is an inflammatory marker associated with cardiovascular disease (CVD) and found to be increased in obesity. Obstructive sleep apnea (OSA) syndrome, a frequent complication of obesity also associated with CVD risk, is improved after surgically-induced weight loss. To explore the potential role of SAA in the relation between OSA and CVD, we investigated relationships between changes in SAA concentrations and nocturnal respiratory events in obese subjects undergoing bariatric surgery.

Daytime hypercapnia in adult patients with obstructive sleep apnea syndrome in France, before initiating nocturnal nasal continuous positive airway pressure therapy.

Context: Daytime hypercapnia in patients with obstructive sleep apnea syndrome (OSAS) has a highly variable prevalence in the published studies, and is usually thought to be the consequence of an associated disease, COPD, or severe obesity.

Study Objectives: To assess the prevalence of daytime hypercapnia in a very large population of adult patients with OSAS, free of associated COPD, and with a wide range of body mass index (BMI), and to evaluate the relationship between daytime hypercapnia and the severity of obesity and obesity-related impairment in lung function.

Design: Retrospective analysis of prospectively collected data.

C-reactive protein and body mass index predict outcome in end-stage respiratory failure.

Study Objective: To determine the predictive factors of morbidity and mortality in patients with end-stage respiratory disease.

Design: Prospective, multicenter cohort study.

Setting: Thirteen outpatient chest clinics within the Association Nationale de Traitement à Domicile de l'Insuffisance Respiratoire.

Prognostic value of nutritional depletion in patients with COPD treated by long-term oxygen therapy: data from the ANTADIR observatory.

Background: An association between weight depletion and mortality has been demonstrated in patients with COPD, but the prognostic influence of malnutrition has not been evaluated in patients with the most severe COPD treated with home long-term oxygen therapy (LTOT).

Study Objective: To analyze the prognostic value of nutritional depletion in patients with COPD receiving LTOT with respect to survival and hospitalization rate.

Design: Analysis of a national database (Observatory of Association Nationale pour le Traitement a Domicile de l'Insuffisance Respiratoire Chronique [ANTADIR]).

Left ventricular systolic dysfunction in patients with obstructive sleep apnea syndrome.

Study Objectives: Conflicting results have been reported regarding the effects of obstructive sleep apnea syndrome (OSAS) on daytime left ventricular (LV) systolic function. This study aimed to assess the prevalence and causes of LV systolic dysfunction, using radionuclide angiography, in a large group of patients with OSAS.

Design And Setting: A prospective study in the pneumology department of a university medical center.

Nutritional depletion in patients on long-term oxygen therapy and/or home mechanical ventilation.

The purpose of this study was to estimate the prevalence of malnutrition in outpatients on long-term oxygen therapy or home mechanical ventilation, to determine the relationships between malnutrition and impairment/disability and smoking and also to identify relevant tools for routine nutritional assessment. In 744 patients (M:F 1.68, aged 65+/-15 yrs) with chronic obstructive pulmonary disease (COPD, 40%), restrictive disorders (27%), mixed respiratory failure (15%), neuromuscular diseases (13%) and bronchiectasis (5%), body mass index (BMI), fat-free mass (FFM), serum albumin, transthyretin, 6-min walking test, forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and blood gases were recorded.

[Sleep apnea syndrome and obesity].

Obesity is a main risk factor for sleep apnea syndrome (SAS). The prevalence of SAS is especially high in massive obesity and in visceral obesity. The mechanisms of obstructive apneas in obesity are poorly known, but an increase in upper airway collapsibility probably plays an important role.

[Acute asthma attack].

A severe form of exacerbation of asthma, AAA is defined by the presence of a least one sign of clinical severity during the attack. AAA is often preceded by prodromal symptoms that should indicate the need to increase maintenance treatment and eliminate possible triggering factors. Initial treatment of AAA should be made as early as possible and should associate high-dose oxygen, nebulisations of beta-2-agonists and corticosteroid infusion.