The SERVE-HF trial investigated the effects of adding adaptive servo ventilation (ASV) (AutoSet CS, ResMed) vs. guideline-based medical treatment alone on survival and cardiovascular outcomes in patients with HFrEF and predominantly CSA. The SERVE-HF trial was an international, multicenter, randomized, parallel-group and event-driven study (clinical trial identifier: NCT00733343). Information about the trial design, procedures, outcomes, and results have been previously reported [5 (link), 6 (link)]. The trial was conducted in accordance with the Good Clinical Practice guidelines and principles of the 2002 Declaration of Helsinki. Institutional Review Board approval was obtained, and all patients signed an informed consent form to participate in the study.
Auto set cs
Manufactured by Resmed
Sourced in Australia
The AutoSet CS is a continuous positive airway pressure (CPAP) device designed to provide respiratory support for patients with sleep-disordered breathing, such as obstructive sleep apnea. The device automatically adjusts the air pressure delivered to the patient based on their breathing patterns, providing the optimal level of pressure required to maintain an open airway throughout the night.
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Lab products found in correlation
9 protocols using auto set cs
1
SERVE-HF: Adaptive Servo Ventilation in HFrEF
2
Randomized Trial of ASV for Heart Failure
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SERVE-HF participants were randomly assigned to receive guideline-based medical treatment alone (control) or guideline-based medical treatment with ASV (Auto Set CS, ResMed). Full details of ASV titration and settings have been reported previously (10 (link)). Substudy evaluations such as PSG were performed at baseline, and at 3 and 12 months after randomization. The substudy was completed when all 312 patients had been followed for 12 months.
3
Advanced Bilevel Positive Airway Pressure for SDB
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The ventilator for ASV therapy used in the present study was an advanced bilevel positive airway pressure unit—AutoSet™ CS (ResMed, Sydney, Australia). The device learns the patient’s breathing rates and patterns, provides proper pressure support that is synchronized to them through its state-of-the-art fuzzy logic algorithms, and generates smooth pressure waveforms mimicking the patient’s normal respiration flow patterns. ASV therapy at home was conducted in patients whose symptoms were stable and for whom the attending physician considered it appropriate. The device is used confinedly in the range of coverage by the National Health Insurance System in Japan. The application of ASV therapy to the treatment of SDB is currently not covered by the system.
4
Comparison of Automatic CPAP Devices
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Nine ASV devices from three different manufacturers were used (SomnoVent CR, SomnoVent Auto ST, from Weinmann, Germany; BiPAP autoSV, BiPAP autoSV 2, BiPAP autoSV 2 (with auto-EPAP), BiPAP autoSV Advanced SO, from Philips Respironics, USA; AutoSet CS, AutoSet CS 2, AutoSet CS PaceWave, from ResMed, USA). Every manufacturer provided different generations of development devices with automatic expiratory positive airway pressure (auto-EPAP) and/or a pressure support that can be reduced to zero (Group II) and devices without any of these features (Group I) (table 1 ).
5
Adaptive Servo-Ventilation for Heart Failure
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SERVE-HF participants were randomised to receive optimal medical therapy for heart failure alone, or in combination with ASV (Auto Set CS, ResMed). For full details of ASV titration and settings, please see the primary study publication [21 (link)]. ASV usage information was downloaded from the device at each follow-up.
6
Adaptive Servo-Ventilation for Heart Failure
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In SERVE‐HF, patients were randomised to receive optimal medical therapy for HF (Ponikowski et al., 2016 (link)) alone, or in combination with ASV (Auto Set CS, ResMed). Full details of ASV titration and settings have been reported previously (Cowie et al., 2015 (link)).
7
Automated Servo-Ventilation Therapy Protocol
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ASV therapy (PaceWave, AutosetCS; ResMed) was initiated in hospital; pressure settings were titrated based on respiratory monitoring and patients were instructed to use the device for ≥5 hours every night. Full details of therapy titration have been reported previously.20 (link) Device data (eg, leak, residual apnoea-hypopnoea index (AHI) and compliance) were downloaded at the first 3-month follow-up visit and then at least every 6 months.
8
Adaptive Servo-Ventilation for Acute Heart Failure
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In this study, we used ASV (AutoSet-CS; ResMed, Sydney, Australia) together with a best-fitted full-face mask (ResMed). The device automatically detects the patient's breathing patterns and provides proper pressure support that is synchronized to these patterns through its fuzzy logic algorithms. It consisted of an expiratory positive airway pressure of 4 cmH2O and suitable minimum-maximum inspiratory support that was within the minimum manufacturer setting range of 3-8 cmH2O. The backup respiratory rate was 15 breaths/min. Basically, the setting ranges, including the expiratory positive airway pressure and inspiratory support, were fixed. If we detected persistent apnea during ASV therapy, ASV titration was performed as necessary. Compliance was assessed based on the ASV use (hours per night) obtained from the data recorded on a memory card built into the ASV device.
In the ASV group, ASV therapy was initiated immediately after admission with medication for acute decompensated HF.
In the ASV group, ASV therapy was initiated immediately after admission with medication for acute decompensated HF.
9
Polysomnographic Evaluation of OSA Patients
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Full-night diagnostic polysomnography (PSG, Rembrandt, USA) was administrated to participants from 22:00 to 6:00 (the second day). The following parameters were recorded (Rembrandt Manager 7.5 Master software, Medicare, USA): electroencephalogram (EEG), electrooculogram (EOG), submental electromyogram (EMG), electrocardiogram, chest and abdominal wall motion, airflow by nasal pressure, and finger pulse oximetry. Sleep architecture, arousals, and respiratory events were analyzed according to the standard criteria recommended by American Academy of Sleep Medicine [10 ]. Apnea was defined as a drop of airflow ≥90% for at least 10 seconds, and hypopnea was defined as a decrease in airflow ≥30% for at least 10 seconds accompanied by oxygen desaturation or arousal. AHI was calculated by the total number of apnea and hypopnea episodes divided by total sleep time. Nocturnal oxygen desaturation was evaluated by minimum SpO2, average SpO2, and sleep time during which SpO2 <90%. All data were scored using a double-blind protocol.
Patients with OSA under CPAP treatment received a second PSG with auto-CPAP titration (Autoset® CS, ResMed, Mönchengladbach, Germany). Positive titration was started with the pressure set at 4 cm H2O. The therapy was considered effective for subjects who displayed an AHI less than 10 events per hour or 75% decrease from baseline.
Patients with OSA under CPAP treatment received a second PSG with auto-CPAP titration (Autoset® CS, ResMed, Mönchengladbach, Germany). Positive titration was started with the pressure set at 4 cm H2O. The therapy was considered effective for subjects who displayed an AHI less than 10 events per hour or 75% decrease from baseline.
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