- Figure 33
ADVENT-HF: Trial Design 2
FIG. 33: The BiPAP autoSV Advanced ASV device used in the ADVENT-HF trial has an automatic algorithm for both CSA and OSA based on peak flow rather than minute ventilation.[12] The default settings for EPAP and inspiratory pressure support are lower than with the Autoset CS device used in SERVE-HF, at 4.0 and 0.0 cmH2O, respectively. As a result, the potential for reducing cardiac output due to reduced preload or causing hyperventilation due to increased inspiratory pressure is much lower in ADVENT-HF.
ADVENT-HF also mandates the use of a nasal mask rather than the full face mask. As shown in this Figure, 78% of the patients are using a nasal mask at home and only 12% are using a full-face mask (the reverse of mask use in SERVE-HF[13]), including patients who open their mouths and get an air leak, where we have to use a full-face mask.
References
Effect of Adaptive Servo Ventilation (ASV) on Survival and Hospital Admissions in Heart Failure (ADVENT-HF). ClinicalTrials.gov Identifier: NCT01128816. https://clinicaltrials.gov/show/NCT01128816
Cowie MR, Woehrle H, Wegscheider K, et al. Adaptive servo-ventilation for central sleep apnea in systolic heart failure. Supplementary appendix. N Engl J Med. 2015; http://www.nejm.org/doi/suppl/10.1056/NEJMoa1506459/suppl_file/nejmoa1506459_appendix.pdf
