Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis

Detalhes bibliográficos
Autor(a) principal: Silva, Bruno C.
Data de Publicação: 2017
Outros Autores: Santos, Roberto S. S., Drager, Luciano F., Coelho, Fernando M. [UNIFESP], Elias, Rosilene M.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: http://dx.doi.org/10.3389/fmed.2017.00057
https://repositorio.unifesp.br/handle/11600/54454
Resumo: Introduction: Obstructive sleep apnea (OSA) is common in edematous states, notably in hemodialysis patients. In this population, overnight fluid shift can play an important role on the pathogenesis of OSA. The effect of compression stockings (CS) and continuous positive airway pressure (CPAP) on fluid shift is barely known. We compared the effects of CS and CPAP on fluid dynamics in a sample of patients with OSA in hemodialysis, through a randomized crossover study. Methods: Each participant performed polysomnography (PSG) at baseline, during CPAP titration, and after 1 week of wearing CS. Neck circumference (NC) and segmental bioelectrical impedance were done before and after PSG. Results: Fourteen patients were studied (53 9 years
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spelling Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysisobstructive sleep apneacompression stockingscontinuous positive airway pressurefluid shifthemodialysisIntroduction: Obstructive sleep apnea (OSA) is common in edematous states, notably in hemodialysis patients. In this population, overnight fluid shift can play an important role on the pathogenesis of OSA. The effect of compression stockings (CS) and continuous positive airway pressure (CPAP) on fluid shift is barely known. We compared the effects of CS and CPAP on fluid dynamics in a sample of patients with OSA in hemodialysis, through a randomized crossover study. Methods: Each participant performed polysomnography (PSG) at baseline, during CPAP titration, and after 1 week of wearing CS. Neck circumference (NC) and segmental bioelectrical impedance were done before and after PSG. Results: Fourteen patients were studied (53 9 years57% menbody mass index 29.7 6.8 kg/m(2)). Apnea hypopnea index (AHI) decreased from 20.8 (14.239.6) at baseline to 7.9 (2.825.4) during CPAP titration and to 16.7 (3.528.9) events/h after wearing CS (CPAP vs. baseline, p = 0.004CS vs. baseline, p = 0.017and CPAP vs. CS, p = 0.017). Nocturnal intracellular trunk water was higher after wearing CS in comparison to baseline and CPAP (p = 0.03). CS reduced the fluid accumulated in lower limbs during the day, although not significantly. Overnight fluid shift at baseline, CPAP, and CS was -183 +/- 72, 343 +/- 220, and 290 +/- 213 ml, respectively (p = 0.006). Overnight NC increased at baseline (0.7 +/- 0.4 cm), decreased after CPAP (-1.0 +/- 0.4 cm), and while wearing CS (-0.4 +/- 0.8 cm) (CPAP vs. baseline, p < 0.0001CS vs. baseline, p = 0.001CPAP vs. CS, p = 0.01). Conclusion: CS reduced AHI by avoiding fluid retention in the legs, favoring accumulation of water in the intracellular component of the trunk, thus avoiding fluid shift to reach the neck. CPAP improved OSA by exerting local pressure on upper airway, with no impact on fluid redistribution. CPAP performed significantly better than CS for both reduction of AHI and overnight reduction of NC. Complementary studies are needed to elucidate the mechanisms by which CPAP and CS reduce NC.Univ Sao Paulo, Dept Med, Renal Div, Sao Paulo, BrazilUniv Fed Espirito Santo, Dept Med, Renal Div, Vitoria, BrazilUniv Sao Paulo, Inst Coracao InCor, Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Psychobiol, Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Neurol & Neurosurg, Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Psychobiol, Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Neurol & Neurosurg, Sao Paulo, BraWeb of ScienceFundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Frontiers Media Sa2020-07-13T11:53:12Z2020-07-13T11:53:12Z2017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion-http://dx.doi.org/10.3389/fmed.2017.00057Frontiers In Medicine. Lausanne, v. 4, p. -, 2017.10.3389/fmed.2017.00057WOS000407112200001.pdf2296-858Xhttps://repositorio.unifesp.br/handle/11600/54454WOS:000407112200001engFrontiers In MedicineLausanneinfo:eu-repo/semantics/openAccessSilva, Bruno C.Santos, Roberto S. S.Drager, Luciano F.Coelho, Fernando M. [UNIFESP]Elias, Rosilene M.reponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2021-10-05T21:28:54Zoai:repositorio.unifesp.br/:11600/54454Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652021-10-05T21:28:54Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis
title Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis
spellingShingle Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis
Silva, Bruno C.
obstructive sleep apnea
compression stockings
continuous positive airway pressure
fluid shift
hemodialysis
title_short Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis
title_full Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis
title_fullStr Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis
title_full_unstemmed Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis
title_sort Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis
author Silva, Bruno C.
author_facet Silva, Bruno C.
Santos, Roberto S. S.
Drager, Luciano F.
Coelho, Fernando M. [UNIFESP]
Elias, Rosilene M.
author_role author
author2 Santos, Roberto S. S.
Drager, Luciano F.
Coelho, Fernando M. [UNIFESP]
Elias, Rosilene M.
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Silva, Bruno C.
Santos, Roberto S. S.
Drager, Luciano F.
Coelho, Fernando M. [UNIFESP]
Elias, Rosilene M.
dc.subject.por.fl_str_mv obstructive sleep apnea
compression stockings
continuous positive airway pressure
fluid shift
hemodialysis
topic obstructive sleep apnea
compression stockings
continuous positive airway pressure
fluid shift
hemodialysis
description Introduction: Obstructive sleep apnea (OSA) is common in edematous states, notably in hemodialysis patients. In this population, overnight fluid shift can play an important role on the pathogenesis of OSA. The effect of compression stockings (CS) and continuous positive airway pressure (CPAP) on fluid shift is barely known. We compared the effects of CS and CPAP on fluid dynamics in a sample of patients with OSA in hemodialysis, through a randomized crossover study. Methods: Each participant performed polysomnography (PSG) at baseline, during CPAP titration, and after 1 week of wearing CS. Neck circumference (NC) and segmental bioelectrical impedance were done before and after PSG. Results: Fourteen patients were studied (53 9 years
publishDate 2017
dc.date.none.fl_str_mv 2017
2020-07-13T11:53:12Z
2020-07-13T11:53:12Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.3389/fmed.2017.00057
Frontiers In Medicine. Lausanne, v. 4, p. -, 2017.
10.3389/fmed.2017.00057
WOS000407112200001.pdf
2296-858X
https://repositorio.unifesp.br/handle/11600/54454
WOS:000407112200001
url http://dx.doi.org/10.3389/fmed.2017.00057
https://repositorio.unifesp.br/handle/11600/54454
identifier_str_mv Frontiers In Medicine. Lausanne, v. 4, p. -, 2017.
10.3389/fmed.2017.00057
WOS000407112200001.pdf
2296-858X
WOS:000407112200001
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Frontiers In Medicine
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv -
dc.coverage.none.fl_str_mv Lausanne
dc.publisher.none.fl_str_mv Frontiers Media Sa
publisher.none.fl_str_mv Frontiers Media Sa
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
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