{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T11:15:16Z","timestamp":1663240516630},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"09","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pneumologie"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Ziel dieser Arbeit war es, festzustellen, ob die Therapie mit einer adaptiven\n      ServoVentilation (ASV) zu einer Hypokapnie und Alkalose f\u00fchrt. Dazu wurde der\n      S\u00e4ure-Basen-Status (SBH) mit Kohlendioxid- und Sauerstoffpartialdruck im arterialisiertem Blut\n      (pCO2 und pO2), Standartbicarbonat (SBC) und pH am Tag spontan atmend und nachts unter ASV\n      gemessen. Ausl\u00f6ser dieser Arbeit war u.a. das Ergebnis der SERVE-HF Studie, welche bei\n      Patienten mit einer Herzinsuffizienz und linksventrikul\u00e4rer Ejektionsfraktion &lt;45% unter\n      der ASV ein erh\u00f6htes Mortalit\u00e4tsrisiko fand. Es gab u.a. die Vermutung eines\n      Ger\u00e4tealgorithmus-basierten Effektes. Als m\u00f6glicher Faktor wurde diskutiert, ob die minimale\n      Druckunterst\u00fctzung (PSmin) von 3 cmH2O \u00fcber eine respiratorische Alkalose einen\n      pro-arrhytmogenen Effekt hat. Eine Studie von Patienten mit therapie-assoziierter zentraler\n      Schlafapnoe (treatment emergent central sleep apnea,TECSA) und normaler Herzfunktion verglich\n      4 ASV-Ger\u00e4te (J. Knitter et al. Comparison of Performance of Four Adaptive Servo Ventilation\n      Devices in Patients with Complex Sleep Apnea, Sleep 2018 Vol. 41 Pages A203-A204). Es fand\n      sich ein signifikant h\u00f6heres Atemminutenvolumen nur mit dem in der SERVE-HF- Studie\n      verwendeten Ger\u00e4t. Somit k\u00f6nnte diese Hyperventilation ein Ger\u00e4te-und kein Klasseneffekt\n      sein.<\/jats:p><jats:p>\n          Patienten 226 Patienten, die zur Verlaufskontrolle oder\n      Neueinstellung der ASV von 10\/2018 bis 03\/2020 kamen: Alter 65,2\u00b111,3 Jahre, BMI\n        35,7\u00b17,5kg\/m2, Gesamtnutzungsdauer 5530\u00b15400 h, 5,6\u00b12,5 h\/d, PSmin 4,9\u00b11,8\n        cmH2O. Alle Patienten hatten eine regelrechte linksventrikul\u00e4re Funktion, der\n      Gro\u00dfteil hatte die ASV wegen TECSA, selten eine kardiale oder ganz selten eine andere\n      Genese.<\/jats:p><jats:p>\n          Ergebnisse Bei 29 Patienten(12,8%) fand sich eine Hypokapnie mit\n        pCO2 morgens &lt; 36 mmHg. <\/jats:p><jats:p>\n          Schlussfolgerung Unter ASV konnten wir bei unseren nichtherzinsuffizienten Patienten eine\n      geringe, aber nicht signifikante Zunahme des pCO2 feststellen. Immerhin hatten 12,8% eine\n      Hypokapnie, die in der H\u00e4lfte der F\u00e4lle so relevant war, dass wir eine Modifikation der\n      Therapie vornahmen. Dies kann verschiedene Ursachen haben, eindeutige Kriterien konnten nicht\n      gefunden werden. Aber es besteht die Gefahr einer Hyperventilation, sodass unter ASV ein SBH\n      erfolgen sollte.<\/jats:p>","DOI":"10.1055\/a-1883-8751","type":"journal-article","created":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T00:27:49Z","timestamp":1663201669000},"page":"606-613","source":"Crossref","is-referenced-by-count":0,"title":["Ist die ASV-Therapie eine \u00dcberdruck- oder eine Beatmungstherapie?\nEin Vergleich des SBH am Tag und unter ASV"],"prefix":"10.1055","volume":"76","author":[{"given":"Andr\u00e9","family":"Barleben","sequence":"additional","affiliation":[{"name":"Pulmologie, Helios Kliniken Schwerin, Schwerin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marika","family":"Allrich","sequence":"additional","affiliation":[{"name":"Pulmologie, Helios Kliniken Schwerin, Schwerin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfram","family":"Gr\u00fcning","sequence":"additional","affiliation":[{"name":"Pulmologie, Helios Kliniken Schwerin, Schwerin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,9,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1378\/chest.13-1778","article-title":"Clinical applications of adaptive servoventilation devices: part 2","volume":"146","author":"S Javaheri","year":"2014","journal-title":"Chest"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1056\/NEJMoa1506459","article-title":"Adaptive Servo-Ventilation for Central Sleep Apnea in Systolic Heart\n          Failure","volume":"373","author":"MR Cowie","year":"2015","journal-title":"N Engl J Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1016\/j.chest.2015.12.021","article-title":"SERVE-HF: More Questions Than Answers","volume":"149","author":"S 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