RT Journal Article
SR Electronic
T1 Polysomnographic assessment of automatic adjustable vs fixed EPAP intelligent volume assured positive airway pressure support in chronic hypoventilation
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA2370
DO 10.1183/13993003.congress-2016.PA2370
VO 48
IS suppl 60
A1 Nigel McArdle
A1 Stuart King
A1 Lisa Erikli
A1 Siobahn Rea
A1 Dinesh Ramanan
A1 Sahisha Ketheeswaran
A1 Jeff Armitstead
A1 Glenn Richards
A1 Bhajan Singh
A1 David Hillman
A1 Peter Eastwood
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA2370.abstract
AB Introduction: An intelligent volume assured positive airway pressure support device has recently been developed to automatically adjust expiratory positive airway pressure (iVAPS AutoEPAP, ResMed Ltd., Bella Vista, Australia).Aims: To evaluate efficacy of the iVAPS AutoEPAP algorithm compared to iVAPS FixedEPAP in treating chronic hypoventilation.Methods: Randomized, double-blind, cross-over, non-inferiority trial of AutoEPAP vs FixedEPAP iVAPSon sleep and breathing over 2 nights of attended polysomnography (PSG). FixedEPAP was determined at a preceding PSG.Results: 25 adults (COPD=11, obesity hypoventilation=9, neuromuscular disease=5) aged 57±7yrs, established on non-invasive ventilation ≥3 months and apnoea/hypopnoea index (AHI)>5.There were no statistical differences between the AutoEPAP and FixedEPAP iVAPS for measures of sleep disordered breathing (Table). All other sleep parameters, including patient mode preference, were equivalent between the two modes.Outcome: Median (IQ range)FixedEPAPAutoEPAPP valueAHI, /hr2.45 (1.3-5.5)2.39 (0.3-5.9)0.9ODI 3%, /hr1.7 (0.8-6.7)1.7 (0.8-6.4)0.7Mean oxygen saturation, %94.1 (92.7-95.5)94.8 (93.4-96.1)0.2Time oxygen saturation<90%, mins2.2 (0.6-9.8)4.4 (0.7-32)0.5Mean transcutaneous CO2, mmHg47.3 (42.6-52)44.7 (42.9-50.4)0.5Conclusions: TheiVAPS AutoEPAP algorithm demonstrated equivalent treatment of breathing and sleep parameters to iVAPS FixedEPAP in chronic hypoventilation patients over the course of a single night's therapy. Advantages over manual titration include ease of implementation of therapy and continuous overnight autotitration to optimise upper airway control.