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. 2023 Mar 23;12(7):2453.
doi: 10.3390/jcm12072453.

Is Intermittent Abdominal Pressure Ventilation Still Relevant? A Multicenter Retrospective Pilot Study

Valeria Volpi  1 , Eleonora Volpato  1   2 , Elena Compalati  1 , Paola Pierucci  3   4 , Antonello Nicolini  1 , Agata Lax  1 , Laura Fagetti  1 , Anna Annunziata  5 , Rosa Cauteruccio  6 , Giuseppe Fiorentino  5 , Paolo Banfi  1
Affiliations

Is Intermittent Abdominal Pressure Ventilation Still Relevant? A Multicenter Retrospective Pilot Study

Valeria Volpi et al. J Clin Med. .

Abstract

Non-invasive ventilatory support (NVS) is a technique used to reduce respiratory work in neuromuscular diseases, preventing the progression of respiratory failure. NVS is usually administered via a nasal or an oronasal mask, causing discomfort, especially in patients ventilated for more than 16 h/day. Intermittent abdominal pressure ventilation (IAPV) differs completely from conventional NVS and consists of a portable ventilator and a corset with Velcro closures as the interface. In our study, the practicability and efficacy of IAPV were studied in three Italian centers monitoring 28 neuromuscular patients using IAPV who were then retrospectively analyzed. The primary outcomes were an improvement in hypoxemia and the normalization of hypercapnia, and the secondary outcome was an improvement in quality of life. Data were collected at baseline (T0) and after two hours of ventilation (T1), with follow-ups at three months (T2) and six months (T3). Statistical significance was found for PaCO2 over time (F (2.42) = 7.63, p = 0.001) and PaO2 (W = 0.539, p = 0.033). The time of NVS usage also significantly affected the quality of life (F (2.14) = 6.90, p = 0.010), as seen when comparing T0 and T3. As an alternative ventilation method, IAPV is still relevant today and could become a key part of daytime support, especially for patients who do not tolerate standard daytime NVS with an oral interface.

Keywords: Duchenne muscular disease (DMD); Pompe disease; amyotrophic lateral sclerosis (ALS); intermittent abdominal pressure ventilation (IAPV); neuromuscular diseases (NMD); non-invasive ventilation (NIV); quality of life; retrospective study.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the participants’ selection.
Figure 2
Figure 2
Distribution of pathologies.
Figure 3
Figure 3
Pairwise Comparisons (Durbin–Conover). Notes: PaO2 = Partial pressure of oxygen; PaCO2 = Partial pressure of carbon dioxide; HCO3− = Bicarbonate.
Figure 4
Figure 4
Development of scores from the SF-12 subscales before and after adaptation to IAPV. Notes: T0 = Baseline; T2 = 3 months; T3 = 6 months; PCS = Physical Component Summary; MCS = Mental Component Summary.
See this image and copyright information in PMC

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