Positive pressure ventilation in Cheyne-Stokes respiration

Cheyne-Stokes respiration (CSR) is found in patients with chronic left ventricular failure and associated with a reduced prognosis. Continuous positive airway pressure (CPAP) improves the survival rate. In this retrospective study we report on the effect of different positive pressure ventilation modes in CSR. The observation period lasted from 1995 - 1999. Inclusion criteria was CSR with a respiratory disturbance index > 10/h whereas > 50 % of the events had to be central and/or mixed. In each patient a 4 week lasting intervention with each of CPAP, Bilevel CPAP in spontan mode (i.e. BiPAP S or BiPAP ST) and BiPAP in controlled mode (i.e. BiPAP T) was performed. Responder were defined by subjective and objective criteria. In total 41 males were included. Responder were distributed as follows: CPAP: n = 13 patients (31.7 %), BiPAP S/ST: n = 9 patients (22.0 %) and BiPAP T: n = 12 patients (29.3 %). In total 7 from 41 patients (17.1 %) rejected a long-term treatment with positive pressure ventilation. The majority of patients with CSR responded to CPAP and BiPAP S/ST mode. Compared to the other responder groups the best quality was reached with BiPAP T. However the latter was performed only by 29 % of the population.