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.
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.
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.
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.
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.