Effects of volume-assured pressure support noninvasive ventilation in stable COPD with chronic respiratory failure: Meta-analysis and literature review.

Abstract

BACKGROUND:

Patients receiving long-term home noninvasive ventilation (NIV) may slow down the progression to acute exacerbation of chronic obstructive pulmonary disease (AECOPD), however, the problem with respiratory instability during sleep diminished was persisted, which may reduce the effectiveness of NIV and the patient's quality of life. A novel NIV mode with volume-assured pressure support (VAPS) has been gradually applied to improve sleep quality in COPD patients with chronic respiratory failure. This meta-analysis aimed to evaluate the efficacy of VAPS in stable COPD patients with chronic respiratory failure.

METHODS:

We performed an electronic literature search for RCTs from January 2008 to October 2018. Studies investigating the effects of VAPS in stable COPD patients with chronic respiratory failure were conducted, and the following primary outcomes were reviewed: effectiveness of ventilation, sleep quality, and quality of life.

RESULTS:

Five studies with 150 subjects were identified. While questionnaire scores showed significant improvements in the VAPS mode, no significant difference was found in the effectiveness of ventilation (pH, MD = 0.01 [95% CI -0.01 to 0.02, P = 0.27]; PaCO2, MD = 1.25 [95% CI -1.45 to 3.95, P = 0.37]; PaO2, MD = 3.14 [95% CI -0.76 to 7.05, P = 0.11]; mSaO2, MD = 0.23 [95% CI -1.22 to 1.67, P = 0.76]; mPtcCO2, MD = 3.03 [95% CI -6.06 to- 0.60, P = 0.10]). The VAPS mode did not seem to ameliorate sleep quality and quality of life.

CONCLUSION:

The VAPS mode had similar efficacy as the pressure-support (PS) mode. However, VAPS could significantly improve the patients' subjective feelings.

• Authors: Xiaomin Zhang, Piaoyu Yang, Chengyao Guo, Shanqun Li, Yuxia Zhang
• Journal: Heart & lung : the journal of critical care (Heart Lung) 2020 May - Jun Vol. 49 Issue 3 Pg. 287-295 ISSN: 1527-3288 [Electronic] United States
• PMID: 32035642 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Topics

• Humans
• Noninvasive Ventilation
• Positive-Pressure Respiration
• Pulmonary Disease, Chronic Obstructive (complications, therapy)
• Quality of Life
• Respiratory Insufficiency (etiology, therapy)