Obstruktive Schlafapnoe bei chronischer Herzinsuffizienz

Die obstruktive Schlafapnoe (OSA) zählt zu den häufigen Komorbiditäten bei chronischer Herzinsuffizienz (HF). Ziel dieser Studie war es, respiratorische Ereignislängen einer obstruktiven Schlafapnoe zu bestimmen und mögliche Korrelationen mit Parametern der Schwere einer Herzinsuffizienz darzustellen. Unabhängig von dieser Studie erhielten 380 Patienten eine Rechts- und Linksherzkatheteruntersuchung sowie eine kardiorespiratorische Polygraphie. 39 Patienten mit obstruktiver Schlafapnoe wurden in diese Studie aufgenommen und der Gruppe der herzinsuffizienten oder der der nicht herzinsuffizienten zugeteilt. Der AHI und der obstruktive Apnoe-Index sind in beiden Gruppen vergleichbar. Die respiratorischen Ereignislängen hingegen sind bei OSA Patienten mit HF ausnahmslos länger. Positive und robuste Korrelationen zwischen Parametern der OSA sowie dem Grad der Stauung konnten lediglich bei OSA Patienten mit HF gezeigt werden

Support Scheme of Food Processing Firms: A Driving Force for Rural Development?

The agri-food sector was given remarkable amounts of funding by all German federal states in the framework of the Measure g ‘Improving Processing and Marketing of Agricultural Products’ within the rural development programs. Based on literature and data we obtained by evaluating this program we identified some indicators representative for illustration of sustainable development, Apart from project data we used the official statistics and the method of case studies. Via selected indicators we received some signs of sustainable development in enterprises of the agri-food industry that also influence the development of rural area. Some statements are restricted because net effects can not be determined. The need for subsidies is discussed as well as possibilities and limits of case studies

Respiratory effects of adaptive servoventilation therapy in patients with heart failure and Cheyne-Stokes respiration compared to healthy volunteers

$\textbf {Background:}$ Nocturnal adaptive servoventilation (ASV) therapy is now frequently used to treat Cheyne-Stokes respiration (CSR), which is highly prevalent in patients with moderate-to-severe heart failure (HF) and characterized by periodical breathing (hyperventilation). $\textbf {Objectives:}$ This study analyzed and compared the acute effects of a novel ASV device on carbon dioxide pressure $(pCO_{2})$ and oxygen saturation $(SaO_{2})$ in HF patients with CSR and healthy volunteers. The influence of being asleep or awake on the ASV algorithm was also determined. $\textbf {Methods:}$ All subjects underwent ASV ($PaceWave^{TM}$, ResMed) for 1 h. Transcutaneous $pCO_{2}$ $(PtcCO_{2})$ and $SaO_{2}$ were assessed transcutaneously, while wakefulness was analyzed using EEG recordings. Assessments were made 30 min before and after ASV, and during 1 h of ASV. $\textbf {Results:}$ Twenty HF patients (19 male; age 79 $\pm$ 12 years) and 15 volunteers (13 male, age 25 $\pm$ 4 years) were included. When awake, ASV was associated with a trend towards a decrease in $PtcCO_{2}$ and an increase in $SaO_{2}$ versus baseline in HF patients (34.4 $\pm$ 3.2 to 33.7 $\pm$ 3.8 mm Hg and 93.8 $\pm$ 2.6 to 94.9 $\pm$ 2.6%, respectively) and volunteers (39.5 $\pm$ 3.0 to 38.2 $\pm$ 3.8 mm Hg and 96.9 $\pm$ 1.3 to 97.8 $\pm$ 0.9%). While asleep during ASV, $PtcCO_{2}$ increased to 36.3 $\pm$ 3.8 mm Hg and $SaO_{2}$ decreased to 93.8 $\pm$ 2.6% in HF patients, with similar changes in volunteers ($PtcCO_{2}$ 41.7 $\pm$ 3.0 mm Hg, $SaO_{2}$ 97.1 $\pm$ 1.2). All comparisons were statistically significant (p $\leq$ 0.05, except the PtcCO2 decrease in both groups when awake). $\textbf {Conclusions:}$ ASV therapy might result in hyperventilation when subjects are awake, but while asleep, $PtcCO_{2}$ increased to mid-normal values, effects that would be favorable in HF patients with CSR