Obstructive sleep apnea (OSA) is a common sleep disorder leading to increased risk of developing cardiovascular diseases (CVDs) by supporting a low-grade chronic inflammation as one of the pathological mechanisms. The continuous positive airway pressure (CPAP) device is used as an effective treatment for moderate and severe OSA. Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), white blood cell-mean platelet volume ratio (WMR), C-reactive protein-albumin ratio (CAR) and fibrinogen-albumin ratio (FAR) are new potential inflammatory biomarkers that are widely available and were shown to be possibly favorable screening or follow-up tools for moderate- or severe-grade OSA, as well as indirect indicators for cardiovascular risk. Our study evaluated the impact of CPAP therapy in patients with severe OSA and acceptable therapy adherence on NLR, PLR, WMR, FAR and CAR. Of 57 patients who were initially enrolled and had no exclusion criteria, 37 had a satisfactory CPAP adherence (usage of ≥4 h per night) after a minimum of 6 months of therapy. There was a statistically significant difference in NLR (2.122 ± 0.745 before therapy vs. 1.888 ± 0.735 after therapy) and FAR (86.445 ± 18.763 before therapy vs. 77.321 ± 19.133 after therapy) suggesting a positive effect of the CPAP therapy on chronic inflammatory states, thereby possibly reducing cardiovascular risk.
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http://dx.doi.org/10.3390/jcm11206113 | DOI Listing |
J Cardiothorac Surg
January 2025
Department of Cardiology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
Background: Continuous Positive Airway Pressure (CPAP) treatment brings more benefits than risks to most coronary heart disease (CHD) patients with obstructive sleep apnea (OSA). However, the pathophysiological mechanism by which CPAP treatment improves the prognosis of patients with CHD and OSA remains unclear. The purpose of this study was to clarify whether CPAP can improve arterial stiffness and inflammatory factor levels in CHD patients with OSA, and to further improve prognosis.
View Article and Find Full Text PDFIntern Med J
January 2025
Department of Respiratory Medicine, The Alfred Health, Melbourne, Victoria, Australia.
Background And Aims: Ward-delivered non-invasive respiratory supports (NIRS) (conventional oxygen therapy (COT), high-flow nasal oxygen (HFNO), continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV)), are often used to treat hospitalised patients with acute respiratory failure (ARF) both in high acuity and general wards. This study aimed to describe the processes of care adopted and examine patient outcomes from a specialist, ward-delivered NIRS service caring for people with COVID-19 in general wards or in a respiratory care unit (RCU).
Methods: A cohort study was undertaken including all consecutive patients admitted to a quaternary hospital with ARF secondary to COVID-19 and requiring ward-delivered NIRS between 28 February 2020 and 18 March 2022.
J Clin Sleep Med
January 2025
Fundación Neumológica Colombiana, Bogotá, Colombia.
Study Objectives: REM-associated OSA (REM OSA) has a prevalence of 17-74% of all OSA cases. At high altitude and in Latin America, there are no data on REM OSA and its relationship to daytime sleepiness and comorbidities. This study aimed to determine the prevalence of REM OSA and the differences in clinical and polysomnographic characteristics between OSA and REM OSA in a population living at 2640 m.
View Article and Find Full Text PDFEClinicalMedicine
January 2025
Department of Anesthesia and Intensive Care Unit, Regional University Hospital of Montpellier, St-Eloi Hospital, University of Montpellier, Montpellier, CEDEX 5, France.
Background: Patients with obesity are at high-risk of extubation failure. Discrepancies were found in the results of recent randomized controlled trials (RCTs) regarding the roles of noninvasive ventilation (NIV), high flow nasal cannula (HFNC) and conventional oxygen therapy (COT) to prevent extubation failure in critically ill patients with obesity.
Methods: In this systematic review and network meta-analysis, we searched MEDLINE, Cochrane Center Register of Controlled Trials and Web of Science from 1 January 1998 to 1 July 2024 for RCTs evaluating noninvasive respiratory support therapies (NIV, HFNC, COT, NIV + HFNC) after extubation in critically ill adults with obesity.
Comput Methods Programs Biomed
December 2024
Politecnico di Milano, Dipartimento di Elettronica, Informazione e Bioingegneria, Piazza Leonardo Da Vinci 32, Milano, MI, 20133, Italy. Electronic address:
Background And Objective: Helmet-Continuous Positive Airway Pressure (H-CPAP) is a non-invasive respiratory support that is used for the treatment of Acute Respiratory Distress Syndrome (ARDS), a severe medical condition diagnosed when symptoms like profound hypoxemia, pulmonary opacities on radiography, or unexplained respiratory failure are present. It can be classified as mild, moderate or severe. H-CPAP therapy is recommended as the initial treatment approach for mild ARDS.
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