Clinical evidence for iVAPS

Clinical evidence for iVAPS

iVAPS' efficacy and tolerability have been established in eight studies.

Study Sample size Patient population Outcome
Oscroft et al.1 25

 Stable hypercapnic COPD, PSV users iVAPS comparable to PSV; PaO2, PaCO2, mean nocturnal oxygenation, lung function, exercise capacity, mean nocturnal tcCO2, health status, compliance equivalent.
Jaye et al.2 18 Stable neuromuscular disease/chest wall, PSV users iVAPS comparable to PSV; nocturnal oxygenation, sleep efficiency, arousals, HR variability equivalent. Slight increase in tcCO2 and decrease in stage 1 sleep.
Battisti et al.3 19 Acute respiratory failure in hypercapnic, stabilized PSV users iVAPS comparable to PSV; PaCO2 and pH improvements, minute volume, pressure support, respiratory rate, haemodynamics equivalent.
Oscroft et al.4 40 COPD patients with compensated ventilatory failure; naïve to NIV iVAPS comparable to PSV; PaO2, PaCO2, mSpO2 and therapy compliance equivalent at 3 months. Time spent in hospital initiating to NIV shorter with iVAPS.
Kelly et al.5 18 Chronic obstructive or Restrictive lung disease; naïve to NIV

 iVAPS comparable to PSV; mSpO2, tcCO2, spirometry, respiratory muscle strength, sleep quality, arousals, O2 desaturation index equivalent. Increase in therapy adherence [>60 minutes) and decrease in median PS with iVAPS.
Ekkernkamp et al.6   27 Stable hypercapnic COPD; PSV users iVAPS comparable to PSV; increase in MV with therapy equivalent to PSV.
Ekkernkamp et al.7   14 Stable hypercapnic COPD; PSV users iVAPS comparable to PSV; Subjectively reported increase in sleep quality with iVAPS. Greater decrease in tcCO2 on iVAPS vs PSV.
Banerjee et al.8 40 COPD patients in chronic ventilatory failure iVAPS comparable to PSV; trend towards shorter time initiative NIV with iVAPS.

COPD: chronic obstructive pulmonary disease; NMD: neuromuscular disease; PaCO2: arterial carbon dioxide pressure; PaO2: arterial oxygen pressure; PSV: pressure support ventilation; tcCO2: transcutaneous carbon dioxide; HR: heart rate; mSpO2: mean blood oxygen saturation; PS: pressure support; MV: minute ventilation.

References
  1. Oscroft NS et al. A randomised crossover trial comparing volume assured and pressure preset noninvasive ventilation in stable hypercapnic COPD. COPD 2010;7(6):398–403. 
  2. Jaye J et al. Autotitrating versus standard noninvasive ventilation: a randomised crossover trial. Eur Respir J2009;33(3):566–573.
  3. Battisti A et al. Automatic adjustment of noninvasive pressure support with a bilevel home ventilator in patients with acute respiratory failure: a feasibility study. Intens Care Med 2007;33(4):632–638. 
  4. Oscroft NS et al. Volume assured versus pressure preset non-invasive ventilation for compensated ventilatory failure in COPD. Respir Med 2014;108(10): 1508¬–1515.
  5. Kelly JL et al. Randomized trial of ‘intelligent’ autotitrating ventilation versus standard pressure support non-invasive ventilation: Impact on adherence and physiological outcomes. Respirology 2014;19(4):596–603.
  6. Ekkernkamp E et al. Minute ventilation during spontaneous breathing, high-intensity noninvasive positive pressure ventilation and intelligent volume assured pressure support in hypercapnic COPD. COPD 2014;11(1):52–58. 
  7. Ekkernkamp E, et al. Impact of intelligent volume-assured pressure support on sleep quality in stable hypercapnic chronic obstructive pulmonary disease patients: a randomized crossover study. Respiration 2014; 88(4): 270–276.  
  8. Banerjee S, et al. Volume assured pressure support ventilation for chronic ventilatory failure in COPD Eur Respir J 2012;40:P2068.