Non-invasive ventilation with intelligent volume-assured pressure support versus pressure-controlled ventilation: effects on the respiratory event rate and sleep quality in COPD with chronic hypercapnia

Figures & data

Figure 1 Study flow chart.

Abbreviations: IVAPS, intelligent volume-assured pressure support; NIV, noninvasive ventilation; PSG, polysomnography; ST, spontaneous timed.

Table 1 Respiratory events

	IVAPS	ST	P-value
UL, n/h	0.3±0.8	0.0±0.0	0.109
Ventilator asynchrony (PVA), n/h	0.2±0.6	0.6±1.5	0.173
PVA + UL, n/h	0.6±1.2	0.6±1.5	0.779
Ventilatory drive, n/h	2.7±3.4	1.8±4.3	0.158
Obstructive hypopneas, n/h	5.1±8.1	3.0±4.6	0.087
Central apneas + hypopneas, n/h	2.7±3.4	1.8±4.5	0.158
Overall events, n/h	8.3±10.2	5.4±6.7	0.064

Note: Values are given as mean ± standard deviation.

Abbreviations: IVAPS, intelligent volume-assured pressure support; PVA, patient ventilator asynchrony; ST, spontaneous timed; UL, unintended leak.

Table 2 Other respiratory parameters

	IVAPS	ST	P-value
SaO2 during NREM, %	92.7±3.5	91.0±3.8	0.036
SaO2 during REM, %	92.2±4.4	90.6±4.8	0.169
Total SaO2, %	92.6±3.5	90.9±3.9	0.034
Respiratory rate during W, breaths/min	17.4±4.0	18.9±3.1	0.026
Respiratory rate during REM, breaths/min	16.0±1.9	17.2±3.2	0.064
Respiratory rate during NREM, breaths/min	15.9±1.8	17.6±3.4	0.016
PtcCO2 during W, mmHg	46.0±6.1	49.6±6.6	0.307
PtcCO2 during REM, mmHg	51.4±6.3	55.0±6.4	0.139
PtcCO2 during NREM, mmHg	50.0±6.6	54.1±5.4	0.078
Total PtcCO2, mmHg	49.1±6.4	52.9±6.2	0.196

Notes: Values are mean ± standard deviation. PtcCO₂, transcutaneous carbon dioxide pressure; SaO₂, oxygen saturation.

Abbreviations: IVAPS, intelligent volume-assured pressure support; NREM, non-rapid eye movement; REM, rapid eye movement; ST, spontaneous timed; W, wake.

Table 3 Ventilation parameters from device

	IVAPS	ST	P-value
IPAP, cmH2O	20.5±3.9	17.9±4.1	0.011
EPAP, cmH2O	5.3±1.3	5.4±1.4	0.317
Leakage, L/min	6.9±10.3	7.1±9.3	0.399
TV, mL	569.3±105.4	549.2±243.5	0.209
RMV, L	9.7±1.8	9.8±3.2	0.463
RR, n/min	16.9±1.7	18.0±3.4	0.065
Inspiratory time, sec	1.2±0.3	1.1±0.3	0.100
Spontaneously cycled breaths, %	38.1±25.3	58.9±28.2	0.007
Alveolar ventilation, L/min	7.7±1.6

Notes: Values are mean ± standard deviation. Alveolar ventilation is estimated as the device’s measured RMV minus correction factor.

Abbreviations: EPAP, expiratory positive airway pressure; IPAP, inspiratory positive airway pressure; IVAPS, intelligent volume-assured pressure support; RMV, respiratory minute volume; RR, respiratory rate; ST, spontaneous timed; TV, tidal volume.

Table 4 Sleep parameters

	IVAPS	ST	P-value
Total sleep time, min	262.9±61.1	268.9±60.6	0.778
Sleep period time, min	344.5±54.4	326.3±59.9	0.140
Time in bed, min	358.8±51.4	332.1±57.3	0.056
NREM sleep, %	84.2±7.8	85.4±7.4	0.379
REM sleep, %	15.8±7.8	14.6±7.4	0.379
N3 sleep, %	29.2±16.3	28.7±12.6	0.727
Sleep efficiency, %	73.9±16.1	80.9±10.7	0.272
WASO, min	83.1±65.8	50.1±38.0	0.233
WASO/sleep period time, %	23.3±16.9	15.2±11.4	0.433
Arousal index, n/h	25.4±9.9	24.4±7.5	0.683
Respiratory arousal index, n/h	4.2±3.1	3.1±3.3	0.510

Note: Values are mean ± standard deviation averaged of all patients.

Abbreviations: IVAPS, intelligent volume-assured pressure support; NREM, non-rapid eye movement; REM, rapid eye movement; ST, spontaneous timed; WASO, wake time after sleep onset.

Table 5 Questionnaire scores (total possible score: 0–45 points; lower scores indicate better patient acceptability)

	IVAPS	ST	P-value
Condition
How did you sleep last night?	2.5±1.3	1.3±1.4	0.445
How intensive is your daytime drowsiness this morning?	0.5±1.2	2.0±1.8	0.018
How would you rate your physical efficiency today?	2.0±1.3	2.3±1.1	0.043
How would you rate your ability to concentrate today?	1.0±0.9	1.5±0.7	0.249
How is your mood today?	1.0±1.0	1.0±1.0	0.281
Total score	7.0±3.6	9.3±3.1	0.108
Side effects
Dry mouth?	2.5±1.8	2.8±1.9	0.554
Weeping?	0.5±1.1	0.5±1.3	0.593
Feeling of coldness in the face?	0.5±0.9	0.0±1.0	0.655
Feeling of pressure in the chest?	0.0±0.0	0.3±0.8	0.655
Total score	4.0±2.9	4.3±3.0	0.813
Overall score	11.5±5.3	13.5±4.2	0.142

Notes: Values are median ± standard deviation, post hoc comparison with Bonferroni–Holm correction showed no significant differences.

Abbreviations: IVAPS, intelligent volume-assured pressure support; ST, spontaneous timed.