Noninvasive Mechanical Ventilation with Average Volume-Assured Pressure Support versus BiPAP S/T in De Novo Hypoxemic Respiratory Failure

Background. Bilevel positive airway pressure in spontaneous/time and average volume-assured pressure support (BiPAP·S/T–AVAPS) could maintain an adequate tidal volume by reducing the patient’s inspiratory effort; however, this ventilatory strategy has not been compared with other ventilatory modes,...

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Main Authors: Killen H. Briones-Claudett, Mónica H. Briones-Claudett, Mariuxi del Pilar Cabrera Baños, Killen H. Briones Zamora, Diana C. Briones Marquez, Luc J. I. Zimmermann, Antonio W. D. Gavilanes, Michelle Grunauer
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Critical Care Research and Practice
Online Access:http://dx.doi.org/10.1155/2022/4333345
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author Killen H. Briones-Claudett
Mónica H. Briones-Claudett
Mariuxi del Pilar Cabrera Baños
Killen H. Briones Zamora
Diana C. Briones Marquez
Luc J. I. Zimmermann
Antonio W. D. Gavilanes
Michelle Grunauer
author_facet Killen H. Briones-Claudett
Mónica H. Briones-Claudett
Mariuxi del Pilar Cabrera Baños
Killen H. Briones Zamora
Diana C. Briones Marquez
Luc J. I. Zimmermann
Antonio W. D. Gavilanes
Michelle Grunauer
author_sort Killen H. Briones-Claudett
collection DOAJ
description Background. Bilevel positive airway pressure in spontaneous/time and average volume-assured pressure support (BiPAP·S/T–AVAPS) could maintain an adequate tidal volume by reducing the patient’s inspiratory effort; however, this ventilatory strategy has not been compared with other ventilatory modes, especially the conventional BiPAP S/T mode, when noninvasive mechanical ventilation (NIMV) is used. The primary objective of this study was to determine the rate of success and failure of the use of BiPAP·S/T-AVAPS versus BiPAP·S/T alone in patients with mild-to-moderate “de novo” hypoxemic respiratory failure. Methods. This was a matched-cohort study. Subjects with mild-to-moderate de novo hypoxemic respiratory failure were divided into two groups according to the ventilatory strategy used. The subjects in the BiPAP·S/T group were paired with those in the BiPAP·S/T-AVAPS group. Results. A total of 58 subjects were studied. Twenty-nine subjects in the BiPAP·S/T group were paired with 29 subjects in the BiPAP·S/T-AVAPS group. Twenty patients (34.5%) presented with “failure of NIMV,” while 38 (65.5%) patients did not. In addition, 13 (22.4%) patients died, while 45 (77.6%) recovered. No differences were found in the percentage of intubation (P=0.44) and mortality (P=0.1). Conclusion. The BiPAP S/T-AVAPS ventilator mode was not superior to the BiPAP·S/T mode. A high mortality rate was observed in patients with NIMV failure in both modes. This trial is registered with https://doi.org/10.1186/ISRCTN17904857.
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spelling doaj-art-0af5026177fa401ea63eb3cdaaef11062025-08-20T02:03:08ZengWileyCritical Care Research and Practice2090-13132022-01-01202210.1155/2022/4333345Noninvasive Mechanical Ventilation with Average Volume-Assured Pressure Support versus BiPAP S/T in De Novo Hypoxemic Respiratory FailureKillen H. Briones-Claudett0Mónica H. Briones-Claudett1Mariuxi del Pilar Cabrera Baños2Killen H. Briones Zamora3Diana C. Briones Marquez4Luc J. I. Zimmermann5Antonio W. D. Gavilanes6Michelle Grunauer7Universidad de Las AmericasIntensive Care UnitIntensive Care UnitUniversidad Espíritu SantoPhysiology and Respiratory-CenterSchool for Oncology and Developmental Biology (GROW)School for Oncology and Developmental Biology (GROW)School of MedicineBackground. Bilevel positive airway pressure in spontaneous/time and average volume-assured pressure support (BiPAP·S/T–AVAPS) could maintain an adequate tidal volume by reducing the patient’s inspiratory effort; however, this ventilatory strategy has not been compared with other ventilatory modes, especially the conventional BiPAP S/T mode, when noninvasive mechanical ventilation (NIMV) is used. The primary objective of this study was to determine the rate of success and failure of the use of BiPAP·S/T-AVAPS versus BiPAP·S/T alone in patients with mild-to-moderate “de novo” hypoxemic respiratory failure. Methods. This was a matched-cohort study. Subjects with mild-to-moderate de novo hypoxemic respiratory failure were divided into two groups according to the ventilatory strategy used. The subjects in the BiPAP·S/T group were paired with those in the BiPAP·S/T-AVAPS group. Results. A total of 58 subjects were studied. Twenty-nine subjects in the BiPAP·S/T group were paired with 29 subjects in the BiPAP·S/T-AVAPS group. Twenty patients (34.5%) presented with “failure of NIMV,” while 38 (65.5%) patients did not. In addition, 13 (22.4%) patients died, while 45 (77.6%) recovered. No differences were found in the percentage of intubation (P=0.44) and mortality (P=0.1). Conclusion. The BiPAP S/T-AVAPS ventilator mode was not superior to the BiPAP·S/T mode. A high mortality rate was observed in patients with NIMV failure in both modes. This trial is registered with https://doi.org/10.1186/ISRCTN17904857.http://dx.doi.org/10.1155/2022/4333345
spellingShingle Killen H. Briones-Claudett
Mónica H. Briones-Claudett
Mariuxi del Pilar Cabrera Baños
Killen H. Briones Zamora
Diana C. Briones Marquez
Luc J. I. Zimmermann
Antonio W. D. Gavilanes
Michelle Grunauer
Noninvasive Mechanical Ventilation with Average Volume-Assured Pressure Support versus BiPAP S/T in De Novo Hypoxemic Respiratory Failure
Critical Care Research and Practice
title Noninvasive Mechanical Ventilation with Average Volume-Assured Pressure Support versus BiPAP S/T in De Novo Hypoxemic Respiratory Failure
title_full Noninvasive Mechanical Ventilation with Average Volume-Assured Pressure Support versus BiPAP S/T in De Novo Hypoxemic Respiratory Failure
title_fullStr Noninvasive Mechanical Ventilation with Average Volume-Assured Pressure Support versus BiPAP S/T in De Novo Hypoxemic Respiratory Failure
title_full_unstemmed Noninvasive Mechanical Ventilation with Average Volume-Assured Pressure Support versus BiPAP S/T in De Novo Hypoxemic Respiratory Failure
title_short Noninvasive Mechanical Ventilation with Average Volume-Assured Pressure Support versus BiPAP S/T in De Novo Hypoxemic Respiratory Failure
title_sort noninvasive mechanical ventilation with average volume assured pressure support versus bipap s t in de novo hypoxemic respiratory failure
url http://dx.doi.org/10.1155/2022/4333345
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