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Advisor(s)
Abstract(s)
Introdução: O CPAP nasal é o tratamento de eleição para os pacientes com Síndrome da
Apneia Obstrutiva do Sono (SAOS). Com a máscara nasal podem ocorrer fugas de ar pela
boca, que podem por em causa a aderência do paciente ao tratamento devido muitas vezes
ao desconforto que provocam, ao aumento do trabalho respiratório e por afectarem a
qualidade do sono.
Objectivos: Este estudo tem como principal objectivo verificar a eficácia da banda
submentoniana e da máscara facial na correcção das fugas pela boca em pacientes com
SAOS.
Métodos e Participantes: Uma amostra de conveniência de 15 pacientes (8 homens) com
SAOS e a fazerem CPAP com máscara nasal, foi recrutada. Foram divididos em dois
grupos A e B, onde no grupo A se colocou a banda submentoniana e no grupo B se alterou
a interface para máscara facial.
Medidas e Resultados: As variáveis avaliadas neste estudo foram as fugas, o IAH, o
percentil 95 da pressão de tratamento, a Sa,O2 e os efeitos adversos das duas intervenções.
O nível de fugas reduziu no grupo A de 38±11,27 para 24,55±14,30L/min (p=0,002) e no
grupo B de 34,34±16,50 para 18,51±16,22L/min (p=0,008). O IAH aumentou no grupo B
de 2,60±2,13 para 4,41±3,88 (p=0,016). Relativamente ao percentil 95 da pressão de
tratamento aumentou nos dois grupos (Grupo A de 10,15±2,63 para 12,08±2,45cmH2O
(p=0,008) e no Grupo B 10,51±1,88 para 12,64±1,29cmH2O (p=0,008)). A Sa,O2 mínima
aumentou e o tempo<90% diminui no grupo A com p=0,008, p=0,031, respectivamente.
Quanto ao uso auto-reportado verificaram-se poucos efeitos adversos, salientando-se
apenas a facilidade de colocação da banda submentoniana, a secura da boca nos dois
grupos, a pressão no queixo provocada pela banda e a dor no dorso do nariz provocada
pela máscara facial.
Conclusão: Ambas as estratégias provaram ser mais eficazes a reduzir a fuga que a
máscara nasal. Foram bem toleradas e com poucos efeitos adversos.
Introduction: Nasal CPAP is the preferred treatment for patients Obstructive Sleep Apnea (OSA). With the nasal mask, air leakage can occur through the mouth, and these leaks may harm patient acceptance to treatment due to the discomfort that often lead to increased work of breathing and affect the quality of sleep. Objectives: This study has as main objective to verify the effectiveness of the chinstrap and the face mask in the correction of mouth leaks in patients with OSA. Methods and Participants: A convenience sample of 15 patients (8 men) with OSA and treated by CPAP with a nasal mask, was recruited. They were divided into two groups A and B, in group A was placed the chinstrap and in Group B the interface has changed to the face mask. Measurements and Results: The variables evaluated in this study were the leakages, the AHI, the 95th percentile of pressure treatment, the oxygen saturation and adverse effects the two interventions. The level of leakage reduced in group A from 38±11.27 to 24.55±14.30 L/min (p = 0.002) and in group B from 34.34±16.50 to 18.51±16.22 L / min (p = 0.008). The AHI increased in group B from 2.60±2.13 to 4.41±3.89 (p = 0.016). For the 95th percentile of pressure increased in both treatment groups (group A from 10.15±2.63 to 12.08±2.45 cmH2O (p = 0.008) and in group B from 10.51±1.88 to 12.64±1.29 cmH2O (p = 0.008)). The minimum oxygen saturation (Sa,O2) increased and the minimum time <90% decrease in group A with p=0.008, p=0.031, respectively. As for using self-reported there were few adverse effects, noting only the ease of placement of chinstrap, the dry mouth in both groups, the chin pressure caused by the chinstrap and the dorse nose pain caused by face mask. Conclusion: Both strategies proved most effective to reduce leakage than nasal mask. Were well tolerated with few adverse effects.
Introduction: Nasal CPAP is the preferred treatment for patients Obstructive Sleep Apnea (OSA). With the nasal mask, air leakage can occur through the mouth, and these leaks may harm patient acceptance to treatment due to the discomfort that often lead to increased work of breathing and affect the quality of sleep. Objectives: This study has as main objective to verify the effectiveness of the chinstrap and the face mask in the correction of mouth leaks in patients with OSA. Methods and Participants: A convenience sample of 15 patients (8 men) with OSA and treated by CPAP with a nasal mask, was recruited. They were divided into two groups A and B, in group A was placed the chinstrap and in Group B the interface has changed to the face mask. Measurements and Results: The variables evaluated in this study were the leakages, the AHI, the 95th percentile of pressure treatment, the oxygen saturation and adverse effects the two interventions. The level of leakage reduced in group A from 38±11.27 to 24.55±14.30 L/min (p = 0.002) and in group B from 34.34±16.50 to 18.51±16.22 L / min (p = 0.008). The AHI increased in group B from 2.60±2.13 to 4.41±3.89 (p = 0.016). For the 95th percentile of pressure increased in both treatment groups (group A from 10.15±2.63 to 12.08±2.45 cmH2O (p = 0.008) and in group B from 10.51±1.88 to 12.64±1.29 cmH2O (p = 0.008)). The minimum oxygen saturation (Sa,O2) increased and the minimum time <90% decrease in group A with p=0.008, p=0.031, respectively. As for using self-reported there were few adverse effects, noting only the ease of placement of chinstrap, the dry mouth in both groups, the chin pressure caused by the chinstrap and the dorse nose pain caused by face mask. Conclusion: Both strategies proved most effective to reduce leakage than nasal mask. Were well tolerated with few adverse effects.
Description
Keywords
Fugas pela boca Banda submentoniana Máscara facial SAOS CPAP Mouth leak Chinstrap Face mask Obstructive sleep apnea Continuous positive airway pressure
Citation
Publisher
Instituto Politécnico do Porto. Escola Superior de Tecnologia da Saúde do Porto