Dados do Trabalho

Título

Influence of Unintentional Air Leaks on PAP Devices: A Systematic Review of Bench Model

Introdução

Obstructive sleep apnea (OSA) due to airway collapse can lead to snoring and apnea. It disrupts sleep, potentially causing intermittent hypoxia and increased sympathetic activity. Effective treatment is crucial; PAP (positive airway pressure) therapy is beneficial but often limited by patient adherence. Since 2002, various bench models have been developed to evaluate PAP devices, compare their performance, simulate respiratory disorder curves, and verify report accuracy. Non-idealities, such as unintentional air leaks, can affect the performance of these devices.

Objetivo

The aim of this study is to review and evaluate bench models and the response of different PAP devices during simulated unintentional air leaks (UIV).

Métodos

The following databases were used to carry out this systematic review: PubMed, Scopus, Web of Science, Embase, SciELO and Google Scholar, using keywords like “bench model,” “sleep apnea,” “PAP devices,” and “positive airway pressure.” Inclusion criteria were studies using bench models to simulate sleep apnea, evaluating PAP devices' effectiveness, published in the last 10 years, and peer-reviewed. Relevant data were collected and analyzed, including the type of bench model, presence of UIV and upper airway model (UAV). Of the 17 articles found, only 12 met the criteria.

Resultados

The systematic review included 12 studies using various bench models to simulate respiratory events during sleep apnea. In 2014, Netzel et al. used a “Hamburg” test lung without NIV (non-invasive ventilation) and a Starling resistor as a UAV model. Zhu et al. in 2015 and 2016 used the lung simulator ASL 5000 with a Starling resistor and leak rates of 0.4 L/s. Isetta et al. used a computer-controlled generator with UIV and a servo-controlled valve in 2015 and 2016. Zhu et al. in 2017 conducted studies with leak rates from 0.5 to 0.91 L/s. In 2023, Fasquel et al. varied leak rates from 0.4 to 0.94 L/s. Unintentional leaks, up to 0.83 L/s, can lead to underestimating the pressure required by automatic PAP devices and overestimating the pressure applied to the respiratory airways.

Conclusões

The reviewed studies show the evolution in simulating sleep apnea using bench models. Leak rates from 0.4 to 0.94 L/s can underestimate the required pressure for OSA treatment and overestimate airway pressure. Accurate bench models is essential for evaluating PAP device performance.

Palavras -chave

Bench model, sleep apnea, upper airway obstruction, positive airway pressure.