Related Experiment Video
Updated: Apr 26, 2026

Inspiratory Muscle Training as an Adjunct to the Treatment of Weaning Failure in Critically Ill Patients: A Practical Guide
Published on: January 30, 2026
Home mechanical ventilation for COPD: high-intensity versus target volume noninvasive ventilation
Jan H Storre1, Elena Matrosovich2, Emelie Ekkernkamp3
1Department of Pneumology, Cologne-Merheim Hospital, Kliniken der Stadt Köln, Witten/Herdecke University Hospital, Cologne Department of Pneumology, University Hospital Freiburg, Freiburg storrej@kliniken-koeln.de.
Background:
High-intensity noninvasive ventilation (HI-NIV) is the most effective means of improving several physiological and clinical parameters in subjects with chronic hypercapnic COPD. Whether the newer hybrid mode using target tidal volume noninvasive ventilation (target V(T) NIV) provides additional benefits remains unclear.
Methods:
Subjects with COPD successfully established on long-term HI-NIV were switched to target V(T) NIV. Optimal target V(T) settings according to nocturnal transcutaneous P(CO2) measurements were achieved following a randomized crossover trial using 8 mL/kg ideal body weight and 110% of individual V(T) during HI-NIV, respectively. The following parameters were compared at the beginning of the trial while subjects were on HI-NIV, and after 3 months on optimal target V(T) NIV: sleep quality by polysomnography, overnight gas exchange, subjects' tolerance, overnight pneumotachygraphic measurements during NIV, health-related quality of life (severe respiratory insufficiency questionnaire), exercise capacity (6-min walk test), and lung function.
Results:
Ten of 14 subjects completed the study. There were no differences between HI-NIV and target V(T) NIV in any of the above-mentioned parameters. Specifically, the mean overnight transcutaneous P(CO2) was equivalent under each form of ventilation (both 45 ± 5 mm Hg, P = .75).
Conclusions:
Switching subjects from well-established HI-NIV to target V(T) NIV shows no clinical benefits in chronic hypercapnic COPD. In particular, sleep quality, the control of nocturnal hypoventilation, daytime hypercapnia, overnight ventilation patterns, subjects' tolerance, health-related quality of life, lung function, and exercise capability were all similar in subjects who underwent HI-NIV and target V(T) NIV. Nevertheless, target V(T) NIV might offer some physiological advantages in breathing pattern and might be beneficial in some individual patients. (German Clinical Trials Register [www.drks.de] Registration DRKS00000450.).
More Related Videos
Related Concept Videos
Mechanical Ventilation II: Invasive Ventilation
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Mechanical Ventilation I: Indication and Settings
Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...
Ventilatory Modes
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
COPD: Management Using Bronchodilators and Corticosteroids
Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...

