{"title":"A novel method for positive airway pressure delivery: pulsating airflow.","authors":"Liran Oren, Ephraim Gutmark, Ann Romaker","doi":"10.5664/jcsm.11466","DOIUrl":null,"url":null,"abstract":"<p><strong>Study objectives: </strong>The primary objective is to determine if pulsating airflow can achieve therapeutic pharyngeal pressure levels without requiring a tight-sealing mask.</p><p><strong>Methods: </strong>A pilot study included 12 nasal-breathing adults who are currently using positive airway pressure (PAP) for therapy. Patients were awake, and pharyngeal pressures were measured using a miniature pressure probe inserted through their nares. Pulsating airflow was applied via a nasal cannula with a customized valve. The inspiratory flow rate was increased until the pharyngeal pressure matched or exceeded the participant's prescribed PAP level. The expiratory flow rate was maintained at a constant low level of continuous airflow.</p><p><strong>Results: </strong>The study demonstrated that pulsating airflow could generate pharyngeal pressures equivalent to or higher than those achieved with PAP therapy in all participants. The peak inspiratory pressures with pulsating airflow followed an oscillatory pattern matching the pulsation frequency. The mean peak pressure increased linearly with the pulsating flow rate. Compared to a high-flow nasal cannula, pulsating airflow produced significantly higher inspiratory pharyngeal pressures, reaching nearly 20 cmH2O.</p><p><strong>Conclusions: </strong>Pulsating airflow could be a viable method for delivering PAP therapy to patients with respiratory or sleep disorders without needing a tight-sealing mask. Further research is required to establish whether this method can improve patient compliance with PAP therapy, assess long-term safety and efficacy, and explore the impact of varying pulsation parameters on treatment outcomes.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":null,"pages":null},"PeriodicalIF":3.5000,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Sleep Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5664/jcsm.11466","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Study objectives: The primary objective is to determine if pulsating airflow can achieve therapeutic pharyngeal pressure levels without requiring a tight-sealing mask.
Methods: A pilot study included 12 nasal-breathing adults who are currently using positive airway pressure (PAP) for therapy. Patients were awake, and pharyngeal pressures were measured using a miniature pressure probe inserted through their nares. Pulsating airflow was applied via a nasal cannula with a customized valve. The inspiratory flow rate was increased until the pharyngeal pressure matched or exceeded the participant's prescribed PAP level. The expiratory flow rate was maintained at a constant low level of continuous airflow.
Results: The study demonstrated that pulsating airflow could generate pharyngeal pressures equivalent to or higher than those achieved with PAP therapy in all participants. The peak inspiratory pressures with pulsating airflow followed an oscillatory pattern matching the pulsation frequency. The mean peak pressure increased linearly with the pulsating flow rate. Compared to a high-flow nasal cannula, pulsating airflow produced significantly higher inspiratory pharyngeal pressures, reaching nearly 20 cmH2O.
Conclusions: Pulsating airflow could be a viable method for delivering PAP therapy to patients with respiratory or sleep disorders without needing a tight-sealing mask. Further research is required to establish whether this method can improve patient compliance with PAP therapy, assess long-term safety and efficacy, and explore the impact of varying pulsation parameters on treatment outcomes.
研究目的:主要目的是确定脉动气流能否在不需要密封面罩的情况下达到治疗性咽压水平:试验研究包括 12 名目前使用气道正压 (PAP) 治疗的鼻呼吸成人。患者保持清醒,使用微型压力探头从鼻孔插入测量咽部压力。通过带有定制阀门的鼻插管施加脉动气流。增加吸气流速,直到咽部压力达到或超过参试者规定的 PAP 水平。呼气流速保持在持续气流的恒定低水平:研究结果表明,脉动气流可产生相当于或高于所有参试者通过 PAP 治疗获得的咽部压力。脉动气流的吸气峰值压力遵循与脉动频率相匹配的振荡模式。平均峰值压力随脉动流速呈线性增长。与高流量鼻插管相比,脉动气流产生的咽部吸气压力明显更高,达到近 20 cmH2O:脉动气流可作为一种可行的方法,为呼吸或睡眠障碍患者提供 PAP 治疗,而无需使用密闭面罩。还需要进一步研究,以确定这种方法是否能提高患者对 PAP 治疗的依从性,评估长期安全性和有效性,并探讨不同脉动参数对治疗效果的影响。
期刊介绍:
Journal of Clinical Sleep Medicine focuses on clinical sleep medicine. Its emphasis is publication of papers with direct applicability and/or relevance to the clinical practice of sleep medicine. This includes clinical trials, clinical reviews, clinical commentary and debate, medical economic/practice perspectives, case series and novel/interesting case reports. In addition, the journal will publish proceedings from conferences, workshops and symposia sponsored by the American Academy of Sleep Medicine or other organizations related to improving the practice of sleep medicine.