nasal pressure support ventilation
The Appropriate Setting of Noninvasive Pressure Support Ventilation in
Stable COPD Patients
Comparison of nasal pressure support ventilation with nasal intermittent
positive pressure ventilation in patients with nocturnal hypoventilation LJ
Restrick, NC Fox, G Braid, EM Ward, EA Paul, and JA Wedzicha
Nasal intermittent positive pressure ventilation (NIPPV) provides effective
ventilatory support in patients with nocturnal hypoventilation. Nasal pressure
support ventilation (NPSV), which only provides ventilation in response to
patient triggering, may also be effective, simpler, and cheaper, but has not
been evaluated. NIPPV and NPSV were compared in 12 patients with nocturnal
hypoventilation, requiring domiciliary ventilatory support. The patients were
studied on three consecutive nights, in random order: a control night without
ventilation and a night on each mode of ventilatory support using the bilevel
positive airway pressure (BiPAP) ventilator. Both NIPPV and NPSV significantly
increased mean arterial oxygen saturation (SaO2) compared to the control night (NIPPV
mean increase 4.1%; 95% confidence interval (CI) 2.2 to 6.1, NPSV 4.4%; CI 2.1
to 6.6) with no significant difference between the two modes. The percentage of
the study night spent below 90% SaO2 was significantly reduced by both
ventilator modes compared to the control night (median reduction on NIPPV 37%;
CI -54 to -10, reduction on NPSV 31%; CI -53 to -9, with no significant
difference between NPSV and NIPPV. NPSV was as effective as NIPPV in patients
with nocturnal hypoventilation, which suggests that these patients are able to
trigger the ventilator adequately. The lower cost of NPSV will make it
accessible to more patients with chronic lung disease.
