EzPAP therapy versus non-invasive ventilation for hypercapnic chronic obstructive pulmonary disease exacerbation: a randomized clinical trial

Abstract

Purpose: EzPAP positive airway pressure (EzPAP) is an innovative device that enhances positive end-expiratory pressure (PEEP) while improving oxygenation. Our study was conducted to assess the efficacy of EzPAP treatment in the management of mild to moderate hypercapnic exacerbations of chronic obstructive pulmonary disease (COPD) MATERIAL AND METHODS: In this prospective controlled study, participants admitted to the emergency department between December 2022 and July 2024 with a diagnosis of hypercapnic COPD exacerbation who were treated with EzPAP or noninvasive ventilation (NIV) were examined. All participants were followed up for 24 h, and blood gas parameters were compared before and after treatment.

Results: 39 out of 95 patients were enrolled in the study. 19 participants received EzPAP, and 20 participants received NIV treatment. In both groups, SaO₂ and pH values increased significantly at 24 h compared to baseline (p < 0.05). The increase in pH value was significantly higher in the EzPAP group compared to the NIV group (p = 0.003). Only in the EzPAP group did the pH value increase significantly at 1 and 4 h compared to baseline (p < 0.05). Only in the EzPAP group, PaO₂ value increased significantly compared to the baseline level at 24 h (p < 0.05).

Conclusions: In our study, we found that EzPAP significantly improved oxygen saturation and alleviated respiratory acidosis more rapidly than NIV in participants with mild to moderate hypercapnic COPD exacerbations. Given these results, EzPAP presents itself as a compelling alternative worth considering.

Keywords: Chronic obstructive pulmonary disease; Exacerbation; EzPAP; Hypercapnia; Non-invasive ventilation.