Supplementum 163 - Swiss Medical Weekly

29 S SWISS MED WKLY 2008;138(Suppl 163) · www.smw.ch
Poster Session 2 - SSP / SGP
eosinophilia was noted. All patients were active smokers and
developed a blood eosinophilia with a latency of 4 to 6 days.
In 2 cases elevated IgE-levels were measured.
Conclusion: Though pulmonary side-effects seem to be rather
uncommon, the possibility of chloroquine-induced pneumonitis
should be considered if a suggestive clinical course exists following
exposure to this substance.
P138
Sleep related breathing disorders in patients with pulmonary
hypertension
S. Ulrich, M. Fischler, R. Speich, K. Bloch.
University Hospital of Zurich (Zurich, CH)
Background: Cheyne-Stokes respiration and central sleep apnea
(CSRA/CSA) are common in patients with left heart failure. We
investigated the hypothesis that sleep disordered breathing is also
prevalent in patients with right ventricular dysfunction due to
pulmonary hypertension.
Methods: We studied 38 outpatients (mean ± SD age 59 ± 16 years,
11 males) with pulmonary arterial hypertension (n = 23) or
thromboembolic pulmonary hypertension (n = 15). NYHA class was
2-4, the 6 minute walk distance was 481 ± 120 m. In-laboratory
polysomnography (n = 22) and ambulatory cardio-respiratory sleep
studies (n = 38) including pulse oximetry were performed. Quality of
life and sleepiness by Epworth score were assessed.
Results: The apnea/hypopnea index was 14±14 events/h with 10 ± 9
central and 3 ± 10 obstructive events/h. Seventeen patients (45%)
had 010 apnea/hypopnea events/h. Comparison of 13 patients with
010 CSR/CSA events/h with 21 patients with 10/h, Epworth score >8) were randomized to autoCPAP or
fixedCPAP therapy at the 90.%-ile of mask pressure during a 2–4
weeks autoCPAP adaptation period. At baseline and at 3 months we
assessed sleepiness, quality of life, AHI, and 24h blood pressure.
Equivalence of CPAP modes was evaluated by computing 95%
confidence intervals of differences in treatment effects.
Results: 74 patients were recruited, 55 were followed-up for
>3 months. Their mean ± SD age was 55 ± 12 y. Data on patients
with complete follow-up at 3 months are presented in the table.
Conclusions: AutoCPAP and fixedCPAP both provided major
improvement in main clinical outcomes of OSA patients. None of the
two modes was superior to the other. Improvement in subjective
sleepiness can be considered equivalent.
Sponsor: Swiss National Science Foundation
P140
The Velumount ® device to treat obstructive sleep apnoea:
does it work?
W. Strobel.
University Hospital Basel (Basel, CH)
Introduction: The Velumount is a non approved device developed to
reduce snoring and obstructive sleep apnoea (OSA). It is applied
intraorally during night and is targeted to remove the soft palate from
the dorsal pharnygeal wall. Despite an almost total lack of published
medical data, due to an intensive media campaign, this device is
widely used in Switzerland.
Methods: I collected data from all sleep apnoea patients of our clinic,
known to have tried the Velumount. I asked for general acceptance of
the device, side effects, reduction of snoring and daytime sleepiness.
In addition, nocturnal oximetries were performed and the results were
compared with the baseline data.
Results: 42 patients of our clinic tried the Velumount device.
Information was available from 39 patients. All 39 patients were
diagnosed with OSA syndrome (AHI 26 ± 11 / h, desaturation index
(DI) = 23 ± 12 / h, Epworth Sleepiness Score (ESS) = 12.2 ± 4.2
points). 19 patients were not able to tolerate CPAP, 20 patients used
CPAP but wanted to try an alternative treatment.
Compared with baseline, at the time of data acquisition under
Velumount treatment, these 39 patients had lost 3.1 ± 3.0 kg of
weight. 17 of these 39 patients (44 %) were not able to tolerate the
Velumount. 22 patients were able to use the Velumount device at
least 4 hours per night. In these 22 patients the ESS fell from 12.5 ±
5.3 to 9.6 ± 4.7 points (p = 0.02). All patients but one reported a clear
reduction in snoring. In 15 of these 22 patients a nocturnal oximetry
under velomount treatment was performed: the DI fell from 22 ± 11 at
baseline to 16 ± 10 / h (p = 0.04). However, in 12 of these 15 patients
the DI under CPAP was 4 ± 4 / h.
Conclusions:
1. Approximately 40% of patients do not cope with the Velumount.
2. Those who manage to use the Velumount feel a significant and
relevant reduction of sleepiness and a clear reduction in snoring.
3. Though statistically significant, the Velumount does not improve
overnight oximetry results relevantly.
4. The changes from baseline described above could be in part due
to a weight loss of approx. 3 kg.
5. Considering the discrepancy between subjective improvement in
sleepiness and only small changes in oximetry, it seems likely, that
some of the beneficial effects of the Velumount are due to a placebo
effect.
6. In conclusion, these scarce data do not support the use of the
Velumount as a sufficient alternative therapy to CPAP.