Chok Limsuwat MD, Warunya Rawangnam MD, Onlak Ruangsomboon MD, Nattakarn Prapruetkit MD
Objectives: The primary goal of this study was to compare patient satisfaction between bi-level positive airway pressure-spontaneous/timed with average volume assured pressure support (BiPAP S/T with AVAPS) and BiPAP S/T alone in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) using self-reported intensity of dyspnea measured with the modified Borg scale (MBS) and a numeric rating scale (NRS) and comfort level measured with a dyspnea and comfort scale.
Methods: This pilot randomized clinical study was conducted in patients who presented with acute respiratory distress due to AECOPD to the Siriraj Hospital Emergency Department. Included patients were randomized in a 1:1 ratio to receive either BiPAP S/T with AVAPS (intervention) or BiPAP S/T (control). MBS, NRS, dyspnea and comfort scale, clinical information, and laboratory results were recorded and analyzed.
Results: Twenty-two patients were enrolled (11 in each group). The average decrease in the MBS, the NRS, and the dyspnea and comfort scale were higher in the group than the control group (4.09 ± 1.81 vs. 2.91 ± 1.64; 4.09 ± 1.76 vs. 2.91 ± 1.92; 3.27 ± 2.45 vs. 3.00 ± 1.90, respectively). The average increase of patient satisfaction with overall comfort was higher in the AVAPS group (1.64 ± 2.77 vs. 1.09 ± 3.02). However, none of these differences reached statistical significance.
Conclusion: There was no statistically significant improvement in patient comfort using AVAPS as an adjunct to standard BiPAP S/T therapy in this pilot study.
Keyword: chronic obstructive pulmonary disease, exacerbation, NIV, AVAPS, emergency department
Article citation: Limsuwat C, Rawangnam W, Ruangsomboon O, Prapruetkit N. Effect of non-invasive mechanical ventilation with average volume assured pressure support (AVAPS) in patients with chronic obstructive pulmonary disease with acute exacerbation: a randomized pilot trial. Southwest Respiratory and Critical Care Chronicles 2019;7(30):19–28
From: Faculty of Medicine Siriraj Hospital (CL, WR, OR, NP), Mahidol University, Bangkok, Thailand; Pulmonary Division, Siriraj Piyamaharajkarun Hospital (CL), Thailand; Internal Medicine, Bumrungrad International Hospital (CL), Thailand
Submitted: 5/20/2019
Accepted: 7/2/2019
Reviewer: Gilbert Berdine MD
Conflicts of interest: none
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