Related Experiment Video

Updated: Oct 31, 2025

Monitoring Lung Function with Electrical Impedance Tomography in the Intensive Care Unit

Monitoring Lung Function with Electrical Impedance Tomography in the Intensive Care Unit

Published on: September 6, 2024

Auto-titrating versus fixed-EPAP intelligent volume-assured pressure support (iVAPS) ventilation in patients with

Doaa M Magdy¹, Ahmed Metwally²

¹Department of Chest Diseases, Faculty of Medicine, Assuit University, Egypt. doaamagdy_2020@yahoo.com.

Advances in Respiratory Medicine

|July 1, 2021

Abstract

Background:

Intelligent volume-assured pressure support (iVAPS) is a new noninvasive ventilation (NIV) mode that can automatically adjust pressure support to deliver effective ventilation. Our aim was to compare treatment efficacy and level of satisfaction between auto-titrating expiratory positive airway pressure (auto-EPAP) and fixed expiratory positive airway pressure (fixed-EPAP) during iVAPS treatment in stable hypercapnic chronic obstructive pulmonary disease (COPD) patients.

Material And Methods:

In this prospective single-blinded, randomized study, 50 patients with chronic stable hypercapnia (COPD) who met the study criteria were randomized into a group I treated with auto-EPAP and a group II who received fixed-EPAP during iVAPS treatment for 5 consecutive days. The patients' characteristics, arterial blood gases, and lung function test were recorded. Numeric rating scale (NRS), dyspnea and comfort scale were obtained. The study subjects were evaluated and followed up after initiating therapy for 5 consecutive days. Outcome measures were recorded at baseline (T0) and after three (T1) and five (T2) days of each consecutive period All parameters were collected and statistically analyzed.

Result:

No significant differences were found regarding age, sex, or BMI between the both groups. It was noted that daytime PaCO2 decreased significantly over the follow-up period in the group I patients treated with auto-EPAP as compared with fixed-EPAP. Regarding the patient comfort and dyspnea during iVAPS treatment, dyspnea sensation was significantly lower with auto-EPAP 7.9 ± 1.8 (T0) vs 3.5 ± 1.1 (T2), p = 0.001 and fixed-EPAP 7.7 ± 1.9 (T0) vs 3.4 ± 1.6 (T2), p = 0.001, but no significance was reached between the both groups. However, auto-EPAP demonstrated significant improvement in comfort when compared with fixed-EPAP modality. However, the overall satisfaction of the patients receiving auto-EPAP modality was significantly increased. Mean tidal volume tended to be higher in auto-EPAP 698 ± 213 mL compared with 628 ± 178 mL in fixed-EPAP (p = 0.001). The air leak was significantly lower in auto-adjusting mode (2.5 ± 1.3 vs 3.7 ± 2.2 L/ min) in fixed-EPAP modality.

Conclusion:

Auto-titrating NIV mode may provide additional benefit in decreasing PaCO2 more efficiently and improve patient comfort and satisfaction.

Keywords:

hypercapnic respiratory failure noninvasive ventilation

More Related Videos

Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device

Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device

Published on: July 20, 2022

Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department

Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department

Published on: January 29, 2011

Related Concept Videos

Mechanical Ventilation III: Noninvasive Ventilation

Mechanical Ventilation III: Noninvasive Ventilation

Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...

Mechanical Ventilation I: Indication and Settings

Mechanical Ventilation I: Indication and Settings

Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...

Ventilatory Modes

Ventilatory Modes

Mechanical ventilators are life-saving devices that support or replace spontaneous breathing. They deliver breaths to patients through varying methods known as ventilator modes. Understanding these modes is critical for healthcare providers managing patients with respiratory failure.
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...

Mechanical Ventilation II: Invasive Ventilation

Mechanical Ventilation II: Invasive Ventilation

Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
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...

Acute Respiratory Failure-V

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...

Acute Respiratory Failure-I

Acute Respiratory Failure-I

Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...

Articles linked to this work by shared authors, journal, and citation graph.

Automated seismic fault mapping using convolutional neural networks for the Berenice Field, Western Desert, Egypt.

Scientific reports·2026

Integrated dry hole, seismic, and structural analysis improves hydrocarbon exploration in the Egyptian Northern Red Sea basin.

Scientific reports·2026

Machine learning driven reservoir property modeling of the AEB-3E reservoir in the Berenice field Egypt.

Scientific reports·2026

Assessment of CO₂ sequestration potential in the Abu Sannan oil field for sustainable energy and environment using seismic modeling, Western Desert, Egypt.

Scientific reports·2025

XGBoost regression for robust acoustic impedance prediction in the absence of density and sonic logs.

Scientific reports·2025

Detailed petrophysical analysis and insights into the Alam El Bueib 3E reservoir from the berenice field, Western desert, Egypt.

Scientific reports·2025

See all related articles