Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2020 Oct;25(10):1073-1081.
doi: 10.1111/resp.13784. Epub 2020 Feb 13.

AVAPS-AE versus ST mode: A randomized controlled trial in patients with obesity hypoventilation syndrome

Maxime Patout  1   2 , Frédéric Gagnadoux  3 , Claudio Rabec  4 , Wojciech Trzepizur  3 , Marjolaine Georges  4 , Christophe Perrin  5 , Renaud Tamisier  6 , Jean-Louis Pépin, Claudia Llontop  7 , Valerie Attali  8   9 , Frederic Goutorbe  10 , Sandrine Pontier-Marchandise  11 , Pierre Cervantes  12 , Vanessa Bironneau  13   14 , Adriana Portmann  1   2 , Jacqueline Delrieu  14 , Antoine Cuvelier  1   2 , Jean-François Muir  1   2   14
Affiliations
Randomized Controlled Trial

AVAPS-AE versus ST mode: A randomized controlled trial in patients with obesity hypoventilation syndrome

Maxime Patout et al. Respirology. 2020 Oct.

Abstract

Background and objective: Average volume-assured pressure support-automated expiratory positive airway pressure (AVAPS-AE) combines an automated positive expiratory pressure to maintain upper airway patency to an automated pressure support with a targeted tidal volume. The aim of this study was to compare the effects of 2-month AVAPS-AE ventilation versus pressure support (ST) ventilation on objective sleep quality in stable patients with OHS. Secondary outcomes included arterial blood gases, health-related quality of life, daytime sleepiness, subjective sleep quality and compliance to NIV.

Methods: This is a prospective multicentric randomized controlled trial. Consecutive OHS patients included had daytime Pa CO2 > 6 kPa, BMI ≥ 30 kg/m2 , clinical stability for more than 2 weeks and were naive from home NIV. PSG were analysed centrally by two independent experts. Primary endpoint was sleep quality improvement at 2 months.

Results: Among 69 trial patients, 60 patients had successful NIV setup. Baseline and follow-up PSG were available for 26 patients randomized in the ST group and 30 in the AVAPS-AE group. At baseline, Pa CO2 was 6.94 ± 0.71 kPa in the ST group and 6.61 ± 0.71 in the AVAPS-AE group (P = 0.032). No significant between-group difference was observed for objective sleep quality indices. Improvement in Pa CO2 was similar between groups with a mean reduction of -0.87 kPa (95% CI: -1.12 to -0.46) in the ST group versus -0.87 kPa (95% CI: -1.14 to -0.50) in the AVAPS-AE group (P = 0.984). Mean NIV use was 6.2 h per night in both groups (P = 0.93). NIV setup duration was shorter in the AVAPS-AE group (P = 0.012).

Conclusion: AVAPS-AE and ST ventilation for 2 months had similar impact on sleep quality and gas exchange.

Keywords: chronic respiratory failure; non-invasive ventilation; obesity hypoventilation syndrome; polysomnography; sleep apnoea.

PubMed Disclaimer

Comment in

References

REFERENCES

    1. Janssens J-P, Derivaz S, Breitenstein E, de Muralt B, Fitting JW, Chevrolet JC, Rochat T. Changing patterns in long-term noninvasive ventilation: a 7-year prospective study in the Geneva Lake area. Chest 2003; 123: 67-79.
    1. Murphy PB, Davidson C, Hind MD, Simonds A, Williams AJ, Hopkinson NS, Moxham J, Polkey M, Hart N. Volume targeted versus pressure support non-invasive ventilation in patients with super obesity and chronic respiratory failure: a randomised controlled trial. Thorax 2012; 67: 727-34.
    1. Borel J-C, Tamisier R, Gonzalez-Bermejo J, Baguet JP, Monneret D, Arnol N, Roux-Lombard P, Wuyam B, Levy P, Pépin JL. Noninvasive ventilation in mild obesity hypoventilation syndrome: a randomized controlled trial. Chest 2012; 141: 692-702.
    1. Pérez de Llano LA, Golpe R, Ortiz Piquer M, Veres Racamonde A, Vázquez Caruncho M, Caballero Muinelos O, Alvarez Carro C. Short-term and long-term effects of nasal intermittent positive pressure ventilation in patients with obesity-hypoventilation syndrome. Chest 2005; 128: 587-94.
    1. Chouri-Pontarollo N, Borel J-C, Tamisier R, Wuyam B, Levy P, Pepin J-L. Impaired objective daytime vigilance in obesity-hypoventilation syndrome: impact of noninvasive ventilation. Chest 2007; 131: 148-55.

Publication types

LinkOut - more resources