The effect of adaptive servo ventilation (ASV) on objective and subjective outcomes in Cheyne-Stokes respiration (CSR) with central sleep apnea (CSA) in heart failure (HF): A systematic review

• Published in: Heart & lung Vol. 45; no. 3; pp. 199 - 211
• Main Authors: Yang, Hyunju, MSN, RN, Sawyer, Amy M., PhD, RN
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2016; Elsevier Science Ltd
• Subjects: Adaptive servo ventilation; Cardiovascular; Cheyne-Stokes respiration; Cheyne-Stokes Respiration - etiology; Cheyne-Stokes Respiration - physiopathology; Cheyne-Stokes Respiration - therapy; Continuous Positive Airway Pressure - methods; Critical Care; Effects; Heart failure; Heart Failure - complications; Heart Failure - physiopathology; Humans; Polysomnography; Pulmonary/Respiratory; Quality of Life; Randomized clinical trial; Respiration; Sleep apnea; Sleep Apnea, Central - complications; Sleep Apnea, Central - physiopathology; Sleep Apnea, Central - therapy; Sleep disordered breathing; Sleep Stages - physiology; Systematic review; Ventilation; Cheyne-Stokes respiration; Heart failure; Adaptive servo ventilation; Systematic review; Randomized clinical trial; Sleep disordered breathing
• ISSN: 0147-9563; 1527-3288
• DOI: 10.1016/j.hrtlng.2016.02.002

Abstract To summarize the current evidence for adaptive servo ventilation (ASV) in Cheyne-Stokes respiration (CSR) with central sleep apnea (CSA) in heart failure (HF) and advance a research agenda and clinical considerations for ASV-treated CSR-CSA in HF. CSR-CSA in HF is associated with higher overall mortality, worse outcomes and lower quality of life (QOL) than HF without CSR-CSA. Five databases were searched using key words ( n  = 234). Randomized controlled trials assessed objective sleep quality, cardiac, and self-reported outcomes in adults (≥18 years) with HF ( n  = 10). ASV has a beneficial effect on the reduction of central sleep apnea in adult patients with CSR-CSA in HF, but it is not be superior to CPAP, bilevel PPV, or supplemental oxygen in terms of sleep quality defined by polysomnography, cardiovascular outcomes, subjective daytime sleepiness, and quality of life. ASV is not recommended for CSR-CSA in HF. It is important to continue to refer HF patients for sleep evaluation to clearly discern OSA from CSR-CSA. Symptom management research, inclusive of objective and subjective outcomes, in CSR-CSA in HF adults is needed.