Noninvasive volume-assured pressure support for chronic respiratory failure: A review

Gaja F. Shaughnessy, Peter C. Gay, Eric J. Olson, Timothy I. Morgenthaler

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)570-577
Number of pages8
JournalCurrent opinion in pulmonary medicine
Issue number6
StatePublished - Nov 1 2019


  • chronic respiratory failure
  • noninvasive ventilation
  • volume-assured pressure support

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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