- \(\textbf {Background:}\) Nocturnal adaptive servoventilation (ASV) therapy is now frequently used to treat Cheyne-Stokes respiration (CSR), which is highly prevalent in patients with moderate-to-severe heart failure (HF) and characterized by periodical breathing (hyperventilation).
\(\textbf {Objectives:}\) This study analyzed and compared the acute effects of a novel ASV device on carbon dioxide pressure \((pCO_{2})\) and oxygen saturation \((SaO_{2})\) in HF patients with CSR and healthy volunteers. The influence of being asleep or awake on the ASV algorithm was also determined.
\(\textbf {Methods:}\) All subjects underwent ASV (\(PaceWave^{TM}\), ResMed) for 1 h. Transcutaneous \(pCO_{2}\) \((PtcCO_{2})\) and \(SaO_{2}\) were assessed transcutaneously, while wakefulness was analyzed using EEG recordings. Assessments were made 30 min before and after ASV, and during 1 h of ASV.
\(\textbf {Results:}\) Twenty HF patients (19 male; age 79 \(\pm\) 12 years) and 15 volunteers (13 male, age 25 \(\pm\) 4 years) were included. When awake, ASV was associated with a trend towards a decrease in \(PtcCO_{2}\) and an increase in \(SaO_{2}\) versus baseline in HF patients (34.4 \(\pm\) 3.2 to 33.7 \(\pm\) 3.8 mm Hg and 93.8 \(\pm\) 2.6 to 94.9 \(\pm\) 2.6%, respectively) and volunteers (39.5 \(\pm\) 3.0 to 38.2 \(\pm\) 3.8 mm Hg and 96.9 \(\pm\) 1.3 to 97.8 \(\pm\) 0.9%). While asleep during ASV, \(PtcCO_{2}\) increased to 36.3 \(\pm\) 3.8 mm Hg and \(SaO_{2}\) decreased to 93.8 \(\pm\) 2.6% in HF patients, with similar changes in volunteers (\(PtcCO_{2}\) 41.7 \(\pm\) 3.0 mm Hg, \(SaO_{2}\) 97.1 \(\pm\) 1.2). All comparisons were statistically significant (p \(\leq\) 0.05, except the PtcCO2 decrease in both groups when awake). \(\textbf {Conclusions:}\) ASV therapy might result in hyperventilation when subjects are awake, but while asleep, \(PtcCO_{2}\) increased to mid-normal values, effects that would be favorable in HF patients with CSR.
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