Influence of different ventilation modes of non-invasive ventilation in patients with hypercapnic-hypoxic ventilation failure – iVAPS vs. ST

<bold>Introduction:</bold> COPD is one of the leading causes of death worldwide. Patients may develop hypercapnic-hypoxic respiratory failure with respiratory acidosis as the disease progresses at an advanced stage. Therefore, with this study, we address the question of whether a modern beaming mode "iVAPS" has an advantage over a conventional mode "ST". <bold>Methods:</bold> This prospective, randomized study with a cross-over design single-blind included 50 patients with COPD GOLD IV/E and hypercapnic-hypoxic ventilation failure at initiation of noninvasive ventilation. After randomization, ventilation was initiated in either ST or iVAPS mode and switched to the other mode after three months. Evaluation parameters included therapy adherence, CO2, quality of life, depression, arterial stiffness, echocardiographic parameters and the 6-minute walk test. <bold>Results:</bold> Results showed significantly better treatment adherence, higher quality of life and improved cognitive performance for iVAPS. The iVAPS mode also led to more effective CO2 elimination. In addition, depending on the duration of use and the mode, there was an advantage for the iVAPS mode in terms of the washed out CO2. <bold>Conclusion:</bold> The study concludes a clear benefit for iVAPS in terms of treatment adherence, quality of life, cognitive performance and mood, but recommends further long-term mortality studies and telemedical monitoring to assess the benefit.