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Copyright ©2014 Baishideng Publishing Group Inc.
World J Cardiol. Nov 26, 2014; 6(11): 1175-1191
Published online Nov 26, 2014. doi: 10.4330/wjc.v6.i11.1175
Table 1 Summary of equipped functions of each type/mode of positive airway pressure
CPAPBi-level PAPVAPSASV
Positive end-expiratory pressure++++
Pressure support during inspiration-+++
Guarantee of tidal volume or minute ventilation--+-
Servo-control of ventilation---+
Automated control of pressure level during expiration+--+
Backup ventilation-±1+2+2
Table 2 Adaptive servo-ventilation devices
Volume-triggered ASVFlow-triggered ASV
ManufacturerResMedPhilips-Respironics
Target90% of previous average ventilation (moving time window)90% of average peak flow (moving time window)
EPAP/EEPEEP automatically adjusted between min and max (4-20 cm H2O) Cannot select auto EEP without PSEPAP automatically adjusted between min and max (4-25 cm H2O)
IPAPMax pressure up to 30 cm H2O IPAP changes within pre-set PS range from min (can be 0) to max Max PS can be limited by maximum pressure and current EEPMax pressure up to 25 cm H2O IPAP changes within pre-set PS range from min (can be 0) to max (21 cm H2O) Max PS can be limited by pre-set maximum pressure and current EPAP level
Backup rateAutomaticAuto rate
15 ±α breaths/minFixed rate
Pressure wave formSaw-toothSquare shape
Inspiratory timeAutomaticAutomatic in auto rate mode
Set in manual rate mode
Table 3 Possible indication of each type/mode of positive airway pressure for each condition
CPAPBi-level PAPVAPSASV
Acute decompensated heart failureo1o?2?
Chronic HF with OSAooΔ3Δ4
Chronic HF with CSAΔ5o?o
HF following acute decompensationΔ6o?Δ7
Chronic HF without SDB×??Δ8
HF with hypoventilation (acute)Δ9oo×
HF with hypoventilation (chronic)Δ9oo?
Table 4 Recommendations for oxygen and bi-level positive airway pressure therapy for acute decompensated heart failure
GuidelinesOxygenPAP therapy
ACC/AHA (2009 updated)To relieve symptoms related to hypoxemia: Class I, level CNA
ACCF/AHA (2013)NANA
HFSA (2010)Hypoxia+: Class I, level CDyspnea+ or pulmonary edema+: Class I, level A
Hypoxia-: Class III, level C
ESC (2012)Hypoxemia+ (SaO2 < 90% or PaO2 < 60 mmHg): Class I, level CDyspnea+ or pulmonary edema+ or RR > 20/min: Class IIa, level B SBP < 85 mmHg: Class III
JCS (2011)Hypoxia+ (to keep SaO2 > 95%, PaO2 > 80 mmHg): Class I, level CNot responding to oxygen: Class I, level A