iVAPS-toimintamuotoon liittyviä kliinisiä todisteita

Tietoja iVAPS-toimintamuodon tehosta ja siedettävyydestä on julkaistu kahdeksassa keuhkoahtaumatautia ja neuromuskulaarisia sairauksia käsittelevässä julkaisussa.

Tutkimus Otannan koko Potilasmäärä Tulos
Oscroft NS et al. A randomised crossover trial comparing volume assured and pressure preset noninvasive ventilator in stage hypercapnic COPD. COPD: Journal of Chronic Obstructive Pulmonary Disease 2010;7:398–403. 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 J et al. Autotitrating versus standard noninvasive ventilation: a randomised crossover trial. Eur Respir J 2009;33:566–573. 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 A et al. Automatic adjustment of noninvasive pressure support with a bilevel home ventilator in patients with acute respiratory failure: a feasibility study. Intensive Care Med 2007;33:632–638. 19 Acute respiratory failure in hypercapnic, stabilized PSV users iVAPS comparable to PSV; PaCO2 and pH improvements, minute volume, pressure support, respiratory rate, hemodynamics equivalent.
Oscroft NS et al. Volume assured versus pressure preset non-invasive ventilation for compensated ventilatory failure in COPD. Resp Med 2014;108:1508–1515. 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 JL et al. Randomized trial of ‘intelligent’ autotitrating ventilation versus standard pressure support non-invasive ventilation: Impact on adherence and physiological outcomes. Respirology 2014;19:596–603. 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 E et al. Impact of intelligent volume assured pressure support on sleep quality, compliance and gas exchange in patients with stable hypercapnic COPD. Eur Resp J 2012;40(56):2064.   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 S et al. Volume assured pressure support ventilation for chronic ventilatory failure in COPD. Eur Respir J 2012;40(56):2068. 40 COPD patients in chronic ventilatory failure iVAPS comparable to PSV; trend towards shorter time initiative NIV with iVAPS.
Jaye J et al. Initiation of nocturnal ventilation using an intelligent autotitrating non-invasive ventilator: Impact on ventilatory efficiency, sleep and adherence. Eur Resp J 2012;40(56):2852. 18

Chronic obstructive or restrictive lung disease and new diagnosed nocturnal hypoventilation iVAPS was found to help patients adhere to therapy for 60 minutes longer (per session) than when treated with standard pressure support ventilation.