Response to high-intensity ventilation in COPD using IVAPs mode.

<bold>Introduction:</bold> The Intelligent Volume-Assured Pressure Support (iVAPS® - ResMed) is an hybrid model of non-invasive ventilation (NIV). Evidence in COPD patients with hypercapnic respiratory failure (HRF) is currently limited. <bold>Objective:</bold> To describe our cohort of COPD patients ventilated with iVAPS and determine if there are differences between those who responded to high intensity (HI) versus those who did not. <bold>Material and Methods:</bold> Retrospective observational study (March 2016 - August 2023) conducted in the Pulmonary Ventilation Unit of H. Sant Pau. COPD in HRF phase with indication of home mechanical ventilation (HMV). Differences were compared between those patients who had achieved normocapnia or achieved a >20% reduction in pCO2 compared to baseline versus those who did not. <bold>Results:</bold> Data were collected from 47 patients (32 males) with a mean age of 68.3 (SD+/-7.4). The most common adaptation type was during a hospitalization for exacerbation (46.8%), followed by a scheduled admission (44.7%). None of the patients experienced serious complications. Compliance during the first month of NIV was >5 hours in 97.9% of cases. Differences were analyzed between the subgroup of patients who responded to HI in the first month (70.2%) and those who did not (29.8%). We observed that patients who did not respond to HI tended to have higher BMI, more leaks, and higher CT90% in pulse oximetry with NIV, although without statistical significance. <bold>Conclusions:</bold> iVAPS is a safe and effective ventilation mode for achieving high intensity in COPD with HRF within the first month after adaptation. More prospective and long-term studies are needed to define if there are differences with the conventional ST mode in this sugroup of patients.