Abstract
Rationale: An unreleased, modified noninvasive ventilator (BiPAP A40, Philips/Respironics, Monroeville, PA) that uses Forced Oscillation Technique (FOT) was evaluated for patient comfort.
Methods: Twelve stable normocapnic COPD participants that were NIV naïve were evaluated for Expiratory Flow Limitation (EFL) using FOT and 3 cmH2O CPAP via an oral-nasal mask while seated and while supine. Six participants with ∆Xrs > 2.8 cmH2O/L/s while supine underwent an overnight NIV study. Each received auto-titrating EPAP starting at 4 cmH2O with fixed pressure support of 6 cmH2O and FOT at 5 Hz in the S/T mode. EPAP auto-titrated until EFL was abolished. Two of the 6 participants repeated the study due to technical issues. A follow up survey evaluated overnight therapy comfort and FOT tolerance.
Results: Demographic, physiologic and observational variables are in Table 1. Overall average EPAP of 9.1 cmH2O (4.3 - 14.9, Std. Dev 3.5, Median 8.05) was required to abolish EFL. At the end of the night, 5 of 6 participants reported slight to extreme therapy comfort. One participant out of the 6 reported FOT and therapy were not comfortable.
Conclusions: NIV naïve COPD patients with moderate to severe airflow limitation tolerated ventilation and FOT. Further investigation of comfort and it’s impact on adherence of FOT in more severe patients using other ventilator modes should be considered.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA4043.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019