Therapy strategy for central breathing disorders -- MEDICA - World Forum for Medicine


Weinmann Geräte für Medizin GmbH & Co. KG

Therapy strategy for central breathing disorders

Stockholm – Patients with heart failure often suffer from central respiratory regulation disorders such as Cheyne-Stokes Breathing and/or obstructive breathing disorders. These problems significantly limit their life expectancy and detract from their quality of life. An innovative approach to the therapy for patients with heart failure involves the supplemental treatment of nocturnal breathing disorders. It has been shown that this type of therapy increases life expectancy. The Hamburg-based medical technology company Weinmann has been providing devices for the treatment of sleep-related breathing disorders for decades. With its new SOMNOvent CR, Weinmann has developed for the first time a device for the special needs of people with cardiovascular diseases and sleep-related breathing disorders.
Therapy devices for breathing disorders in which the patient's airways close during sleep (e.g., sleep apnea) work by providing a "splint" in the airways generated by positive pressure ventilation. The therapy for central respiratory disorders such as Cheyne-Stokes Breathing requires an "intelligent" adjustment of the "ventilation" in response to each situation. To that end, the therapy strategies for the treatment of obstructive events have to be combined with those for the treatment of periodic events.
Intelligent Adjustment to Different Manifestations
Cheyne-Stokes Breathing is characterized by a crescendo-decrescendo pattern in tidal volumes with long apneas alternating with phases of hyperventilation. Such respiratory disorders require a highly sophisticated ventilation therapy in which the therapy device has to react to different situations and manifestations all the time. This type of therapy is described as anti-cyclical modulated ventilation or adaptive servo-ventilation. The Weinmann CR mode uses and augments these processes. Three different pressure levels are adjusted to the current needs of the patient during inspiration (IPAP), at the start of expiration (EPAP) and at the end of expiration (EEPAP). In cases of obstructions such as apnea, hypopnea, flow limitations and snoring, and in cases of increasing or decreasing tidal volume, the device reacts immediately and regulates breathing back to normal. When the patient once again breathes normally, pressure relief is automatically applied.
Quick Relief for Patients
In comparison to conventional treatment, therapy with anti-cyclical modulated ventilation has several advantages:

Respiratory fluctuations are counter-balanced anti-cyclically and pathophysiological mechanisms of breathing are modulated in the physiological direction. These responses suppress hyperventilation.

Both central and obstructive breathing patterns are registered and therapeutically regulated with great efficiency.

Because the regulation is gentle, restorative sleep is ensured.

During the course of the night, the intelligent algorithm continuously adjusts to the patient, thus guaranteeing optimum therapy.
"This innovative therapy device provides patients with quick relief," said Stefan Jentsch, Sleep Therapy Product Manager at Weinmann.