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Research ArticleOriginal Research

Volume-Targeted Versus Pressure-Limited Noninvasive Ventilation in Subjects With Acute Hypercapnic Respiratory Failure: A Multicenter Randomized Controlled Trial

Zhixin Cao, Zujin Luo, Anna Hou, Qingrong Nie, Baoyuan Xie, Xiaojie An, Zifen Wan, Xianwei Ye, Yanju Xu, Xisheng Chen, Honghai Zhang, Zhenyang Xu, Jinxiang Wang, Fucheng An, Pengfei Li, Chunxiao Yu, Yandong Liang, Yongxiang Zhang and Yingmin Ma
Respiratory Care November 2016, 61 (11) 1440-1450; DOI: https://doi.org/10.4187/respcare.04619
Zhixin Cao
Department of Respiratory and Critical Care Medicine, Beijing Engineering Research Center of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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  • For correspondence: [email protected] [email protected]
Zujin Luo
Department of Respiratory and Critical Care Medicine, Beijing Engineering Research Center of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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Anna Hou
Department of Respiratory and Critical Care Medicine, Beijing Engineering Research Center of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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Qingrong Nie
Department of Respiratory Medicine, Liangxiang Hospital of Beijing Fangshan District, Beijing, China.
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Baoyuan Xie
Department of Respiratory Medicine, Liangxiang Hospital of Beijing Fangshan District, Beijing, China.
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Xiaojie An
Department of Respiratory Medicine, Liangxiang Hospital of Beijing Fangshan District, Beijing, China.
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Zifen Wan
Department of Respiratory and Critical Care Medicine, The People's Hospital of Guizhou Province, Guiyang, Guizhou, China.
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Xianwei Ye
Department of Respiratory and Critical Care Medicine, The People's Hospital of Guizhou Province, Guiyang, Guizhou, China.
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Yanju Xu
Department of Respiratory and Critical Care Medicine, The People's Hospital of Guizhou Province, Guiyang, Guizhou, China.
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Xisheng Chen
Department of Respiratory Medicine, Beijing Shunyi District Hospital, Beijing, China.
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Honghai Zhang
Department of Respiratory Medicine, Beijing Shunyi District Hospital, Beijing, China.
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Zhenyang Xu
Department of Respiratory and Critical Care Medicine, The People's Hospital of Guizhou Province, Guiyang, Guizhou, China.
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Jinxiang Wang
Department of Respiratory and Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, China.
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Fucheng An
Department of Respiratory Medicine, Beijing Mentougou District Hospital, Beijing, China.
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Pengfei Li
Department of Respiratory Medicine, Beijing Mentougou District Hospital, Beijing, China.
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Chunxiao Yu
Department of Respiratory Medicine, Beijing Jingmei Group General Hospital, Beijing, China.
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Yandong Liang
Department of Respiratory Medicine, Beijing Jingmei Group General Hospital, Beijing, China.
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Yongxiang Zhang
Department of Respiratory Medicine, Daxing Teaching Hospital, Capital Medical University, Beijing, China.
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Yingmin Ma
Department of Respiratory Medicine, Daxing Teaching Hospital, Capital Medical University, Beijing, China.
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  • For correspondence: [email protected] [email protected]
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    Fig. 1.

    Flow chart. NIV = noninvasive ventilation.

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    Fig. 2.

    SD of tidal volume (A) and peak inspiratory pressure (B) during the first 6 h after randomization. Points denote individual values and horizontal lines denote means. In both panels, P < .001 between the pressure-limited noninvasive ventilation group (PL-NIV) and volume-targeted noninvasive ventilation group (VT-NIV).

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    Fig. 3.

    Daily use of noninvasive ventilation during the first 5 d after randomization. Values are given as means, and error bars denote SD. PL-NIV = pressure-limited noninvasive ventilation; VT-NIV = volume-targeted noninvasive ventilation.

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    Fig. 4.

    Decrement of PaCO2 from baseline to 6 h after randomization (A) and from baseline to 2 h after randomization (B). Points denote individual values, and solid horizontal lines denote means. PL-NIV = pressure-limited noninvasive ventilation; VT-NIV = volume-targeted noninvasive ventilation.

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    Fig. 5.

    Scale for accessory muscle use (A), breathing frequency (B), SpO2 (C), arterial pH (D), PaCO2 (E), and PaO2/FIO2 (F) at baseline (0 h) and after randomization in subjects receiving pressure-limited noninvasive ventilation (PL-NIV) and volume-targeted noninvasive ventilation (VT-NIV). Values are given as mean ± SD. *, P < .05 compared with baseline within the same group.

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    Fig. 6.

    Kaplan-Meier plot of the cumulative incidence of intubation (A), the cumulative probability of remaining on noninvasive ventilation (B), and the cumulative probability of survival (C) within 28 d after randomization. PL-NIV = pressure-limited noninvasive ventilation; VT-NIV = volume-targeted noninvasive ventilation. P values are by log-rank test.

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Respiratory Care: 61 (11)
Respiratory Care
Vol. 61, Issue 11
1 Nov 2016
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Volume-Targeted Versus Pressure-Limited Noninvasive Ventilation in Subjects With Acute Hypercapnic Respiratory Failure: A Multicenter Randomized Controlled Trial
Zhixin Cao, Zujin Luo, Anna Hou, Qingrong Nie, Baoyuan Xie, Xiaojie An, Zifen Wan, Xianwei Ye, Yanju Xu, Xisheng Chen, Honghai Zhang, Zhenyang Xu, Jinxiang Wang, Fucheng An, Pengfei Li, Chunxiao Yu, Yandong Liang, Yongxiang Zhang, Yingmin Ma
Respiratory Care Nov 2016, 61 (11) 1440-1450; DOI: 10.4187/respcare.04619

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Volume-Targeted Versus Pressure-Limited Noninvasive Ventilation in Subjects With Acute Hypercapnic Respiratory Failure: A Multicenter Randomized Controlled Trial
Zhixin Cao, Zujin Luo, Anna Hou, Qingrong Nie, Baoyuan Xie, Xiaojie An, Zifen Wan, Xianwei Ye, Yanju Xu, Xisheng Chen, Honghai Zhang, Zhenyang Xu, Jinxiang Wang, Fucheng An, Pengfei Li, Chunxiao Yu, Yandong Liang, Yongxiang Zhang, Yingmin Ma
Respiratory Care Nov 2016, 61 (11) 1440-1450; DOI: 10.4187/respcare.04619
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Keywords

  • acute hypercapnic respiratory failure
  • noninvasive ventilation
  • volume-targeted
  • pressure-limited
  • target tidal volume
  • hypercapnia

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