TY - JOUR
T1 - Noninvasive volume-assured pressure support for chronic respiratory failure
T2 - A review
AU - Shaughnessy, Gaja F.
AU - Gay, Peter C.
AU - Olson, Eric J.
AU - Morgenthaler, Timothy I.
N1 - Funding Information:
Noninvasive ventilation (NIV) is an established treatment for chronic hypercapnic respiratory failure (CRF). Volume-assured pressure support (VAPS) is a mode of NIV that automatically adjusts inspiratory pressure in order to maintain a constant respiratory volume. We aim to discuss the role and application of VAPS in CRF.
Publisher Copyright:
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PY - 2019/11/1
Y1 - 2019/11/1
N2 - Purpose of reviewNoninvasive ventilation (NIV) is an established treatment for chronic hypercapnic respiratory failure (CRF). Volume-assured pressure support (VAPS) is a mode of NIV that automatically adjusts inspiratory pressure in order to maintain a constant respiratory volume. We aim to discuss the role and application of VAPS in CRF.Recent findingsRecently published meta-analyses and reviews fail to demonstrate a significant difference in gas exchange, sleep, or quality-of-life improvement between VAPS and bilevel positive airway pressure (BPAP) in patients with CRF. A recent manuscript suggests that VAPS therapy in chronic obstructive pulmonary disease patients may reduce the number of exacerbations. It has been shown that with a protocol-driven approach BPAP and VAPS can both be successfully titrated during a single split-night polysomnography.SummaryVAPS is as effective as other modes of NIV at improving ventilation and sleep in CRF. The potential advantage is a more consistent ventilatory support through daytime-nighttime variations and progression of disease over time. However, the impact on long-term outcomes, such as survival, has not been studied.
AB - Purpose of reviewNoninvasive ventilation (NIV) is an established treatment for chronic hypercapnic respiratory failure (CRF). Volume-assured pressure support (VAPS) is a mode of NIV that automatically adjusts inspiratory pressure in order to maintain a constant respiratory volume. We aim to discuss the role and application of VAPS in CRF.Recent findingsRecently published meta-analyses and reviews fail to demonstrate a significant difference in gas exchange, sleep, or quality-of-life improvement between VAPS and bilevel positive airway pressure (BPAP) in patients with CRF. A recent manuscript suggests that VAPS therapy in chronic obstructive pulmonary disease patients may reduce the number of exacerbations. It has been shown that with a protocol-driven approach BPAP and VAPS can both be successfully titrated during a single split-night polysomnography.SummaryVAPS is as effective as other modes of NIV at improving ventilation and sleep in CRF. The potential advantage is a more consistent ventilatory support through daytime-nighttime variations and progression of disease over time. However, the impact on long-term outcomes, such as survival, has not been studied.
KW - chronic respiratory failure
KW - noninvasive ventilation
KW - volume-assured pressure support
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U2 - 10.1097/MCP.0000000000000605
DO - 10.1097/MCP.0000000000000605
M3 - Article
C2 - 31306163
AN - SCOPUS:85072904833
SN - 1070-5287
VL - 25
SP - 570
EP - 577
JO - Current Opinion in Pulmonary Medicine
JF - Current Opinion in Pulmonary Medicine
IS - 6
ER -