Pulmonary artery hypertension and sleep-disordered breathing: ACCP evidence-based clinical practice guidelines

American College of Chest Physicians - Medical Specialty Society     发表于2004年

Based on the available evidence, the following recommendations were accepted by the American College of Chest Physicians Guidelines committee for the evaluation of sleep disordered breathing in the setting of idiopathic pulmonary arterial hypertension (IPAH), for the evaluation pulmonary arterial hypertension (PAH) in the setting of obstructive sleep apnea (OSA), and for the treatment of OSA and its effect on PAH. 1. In the evaluation of patients with pulmonary arterial hypertension (PAH), an assessment of sleep-disordered breathing (SDB) is recommended. Quality of evidence: low; net benefit: small/weak; strength of recommendation: C. 2. In the evaluation of a patient with PAH for SDB, polysomnography is recommended if obstructive sleep apnea (OSA) is suspected as the etiology, if a screening test result for OSA is positive, or if a high clinical suspicion for OSA is present. Quality of evidence: expert opinion; net benefit: intermediate; strength of recommendation: E/B. 3. In the management of patients with OSA, routine evaluation for the presence of PAH is not recommended. Quality of evidence: low; net benefit: none; strength of recommendation: I. 4. In patients with OSA and PAH, treatment of OSA with positive airway pressure therapy should be provided with the expectation that pulmonary pressures will decrease, although they may not normalize, particularly when PAH is more severe. Quality of evidence: low; net benefit: small/weak; strength of recommendation: C....查看全文