Non invasive volume assured pressure support versus conventional pressure support in patients with respiratory failure due to chronic obstructive pulmonary disease

K. Hussein (Assiut, Egypt)

Source: Respiratory Failure and Mechanical Ventilation Conference 2022 - Opening session: Essentials of respiratory physiology - Assessment of respiratory muscle function - Pulmonary infections in mechanically ventilated patients - Telemonitoring of patients with chronic respiratory failure - Diagnostics and interventions - Acute respiratory failure: COVID-19 - Interstitial lung disease and pulmonary hypertension - Early rehabilitation - Acute respiratory failure: Invasive mechanical ventilation - HFNO and NIV for acute hypoxemic failure - Longterm NIV miscellaneous - Controversies in acute respiratory failure - The role of respiratory muscle dysfunction in weaning failure - Transitions in chronic NIV - New insights in weaning from invasive ventilation - Noninvasive ventilation (NIV) in the clinical practice: How do I do it? - Difficult weaning from mechanical ventilation - Chronic ventilatory support in different diseases: Is one way fitting all? - Strategies to optimise early mobilisation and rehabilitation in intensive care - Noninvasive ventilation (NIV) in the clinical practice: How do I do it? - Acute respiratory failure: Hypercapnic and diagnosis

Session: Acute respiratory failure: Hypercapnic and diagnosis
Session type: Oral poster discussion
Number: 101

Abstract

Background
Effective non-invasive ventilation (NIV) is dependent on optimal ventilator settings for alveolar ventilation. Volume-assured pressure support (VAPS) is a mode of servoventilation, providing constant automatic adjustment of pressure support (PS) to achieve a target ventilation.

Objective

To evaluate the effectiveness of volume assured pressure support (VAPS) in comparison with conventional pressure support using S/T mode in-patients with acute hypercapnic respiratory failure due to acute exacerbation of COPD.
Patients and methods
40 patients with hypercapnic respiratory failure and respiratory acidosis due to COPD after failure of standard medical treatment including oxygen therapy were recruited into the study. Patients were categorized into two groups, Group I ventilated with S/T mode and Group II ventilated with VAPS mode. Patients were fitted with an oronasal mask.

Results

Both groups were comparable on admission. The successful outcome was achieved in 15 patients (75%) in the PS group vs 16 patients (80%) in the VAPS group. In the VAPS group, there were a significantly (p < 0.01) higher pH (7.34 ± 0.02 vs 7.31 ± 0.02 for PS group) and significantly (p < 0.001) lower PaCO2 (74.00 ± 2.3 vs 79.00 ± 3.7 for PS group) after 1 h NIV.

There was a significant (p < 0.01) higher minute ventilation and significant (p < 0.001) lower peak inspiratory pressure in the VAPS group after 1 h, and 6 h NIV.

Conclusion

Non invasive VAPS is characterized by stable alveolar ventilation with lower and variable inspiratory pressure and earlier improvement of respiratory acidosis when compared with conventional pressure support.

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Citations should be made in the following way:
K. Hussein (Assiut, Egypt). Non invasive volume assured pressure support versus conventional pressure support in patients with respiratory failure due to chronic obstructive pulmonary disease. Respiratory Failure and Mechanical Ventilation Conference 2022 - Opening session: Essentials of respiratory physiology - Assessment of respiratory muscle function - Pulmonary infections in mechanically ventilated patients - Telemonitoring of patients with chronic respiratory failure - Diagnostics and interventions - Acute respiratory failure: COVID-19 - Interstitial lung disease and pulmonary hypertension - Early rehabilitation - Acute respiratory failure: Invasive mechanical ventilation - HFNO and NIV for acute hypoxemic failure - Longterm NIV miscellaneous - Controversies in acute respiratory failure - The role of respiratory muscle dysfunction in weaning failure - Transitions in chronic NIV - New insights in weaning from invasive ventilation - Noninvasive ventilation (NIV) in the clinical practice: How do I do it? - Difficult weaning from mechanical ventilation - Chronic ventilatory support in different diseases: Is one way fitting all? - Strategies to optimise early mobilisation and rehabilitation in intensive care - Noninvasive ventilation (NIV) in the clinical practice: How do I do it? - Acute respiratory failure: Hypercapnic and diagnosis

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