Is Intermittent Abdominal Pressure Ventilation Still Relevant? A Multicenter Retrospective Pilot Study

Area of Science:

• Respiratory Medicine
• Biomedical Engineering
• Neurology

Background:

• Non-invasive ventilatory support (NVS) is crucial for managing respiratory failure in neuromuscular diseases.
• Conventional NVS interfaces (nasal/oronasal masks) can cause significant discomfort during prolonged use (>16 h/day).
• Intermittent abdominal pressure ventilation (IAPV) presents a novel approach using a portable ventilator and abdominal corset.

Purpose of the Study:

• To evaluate the practicability and efficacy of IAPV in neuromuscular patients.
• To assess IAPV's impact on hypoxemia, hypercapnia, and quality of life.
• To explore IAPV as an alternative to standard NVS for patients with intolerance.

Main Methods:

• Retrospective analysis of 28 neuromuscular patients using IAPV across three Italian centers.
• Data collection at baseline (T0), 2 hours (T1), 3 months (T2), and 6 months (T3).
• Primary outcomes: improvement in hypoxemia (PaO2) and normalization of hypercapnia (PaCO2). Secondary outcome: quality of life.

Main Results:

• Significant improvements in PaCO2 over time (p=0.001) and PaO2 (p=0.033).
• Quality of life significantly improved from baseline to 6 months (p=0.010).
• IAPV demonstrated effectiveness in improving key respiratory parameters and patient well-being.

Conclusions:

• IAPV is a viable and effective alternative to conventional NVS for neuromuscular patients.
• IAPV can improve respiratory failure markers and enhance quality of life.
• IAPV holds potential as a key component of daytime ventilatory support, particularly for those intolerant to standard interfaces.