Skip to main content
 

Main menu

  • Home
  • Content
    • Current Issue
    • Editor's Commentary
    • Coming Next Month
    • Archives
    • Most-Read Papers of 2021
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Reviewer Guidelines: Original Research
    • Reviewer Guidelines: Reviews
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • 2022 Call for Abstracts
    • 2021 Abstracts
    • Previous Open Forums
  • Podcast
    • English
    • Español
    • Portugûes
    • 国语
  • Videos
    • Video Abstracts
    • Author Interviews
    • Highlighted Articles
    • The Journal

User menu

  • Subscribe
  • My alerts
  • Log in

Search

  • Advanced search
American Association for Respiratory Care
  • Subscribe
  • My alerts
  • Log in
American Association for Respiratory Care

Advanced Search

  • Home
  • Content
    • Current Issue
    • Editor's Commentary
    • Coming Next Month
    • Archives
    • Most-Read Papers of 2021
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Reviewer Guidelines: Original Research
    • Reviewer Guidelines: Reviews
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • 2022 Call for Abstracts
    • 2021 Abstracts
    • Previous Open Forums
  • Podcast
    • English
    • Español
    • Portugûes
    • 国语
  • Videos
    • Video Abstracts
    • Author Interviews
    • Highlighted Articles
    • The Journal
  • Twitter
  • Facebook
  • YouTube
Research ArticleOriginal Research

Alveolar Ventilation-Targeted vs. Spontaneous/Timed Mode for Home Non-Invasive Ventilation in Amyotrophic Lateral Sclerosis

Pattaraporn Panyarath, Veronique Adam, R John Kimoff and Marta Kaminska
Respiratory Care March 2022, respcare.09580; DOI: https://doi.org/10.4187/respcare.09580
Pattaraporn Panyarath
Respiratory Division and Sleep Laboratory McGill University Health Centre (MUHC), Montreal, Quebec, Canada.
Division of Respiratory and Respiratory Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Veronique Adam
Quebec National Program for Home Ventilatory Assistance (NPHVA), MUHC, Montreal, Quebec, Canada.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
R John Kimoff
Respiratory Division and Sleep Laboratory McGill University Health Centre (MUHC), Montreal, Quebec, Canada.
Center for Research Outcomes Evaluation MUHC, Montreal, Quebec, Canada.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Marta Kaminska
Respiratory Division and Sleep Laboratory McGill University Health Centre (MUHC), Montreal, Quebec, Canada.
Center for Research Outcomes Evaluation MUHC, Montreal, Quebec, Canada.
Quebec National Program for Home Ventilatory Assistance (NPHVA), MUHC, Montreal, Quebec, Canada.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • References
  • Info & Metrics
  • PDF
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Introduction: Home noninvasive ventilation (NIV) is increasingly used in ALS to improve symptoms and survival. Our primary objective was to compare iVAPS vs. ST modes regarding time to first change in ventilator parameters and the number of interventions over 6 months in subjects with ALS in a respiratory therapist (RT)-led program.

Methods: In this study, 30 subjects with ALS meeting criteria for NIV initiation were randomized to iVAPS or ST. NIV was initiated using standardized protocols targeting optimal tidal volume and comfort in a daytime session. “Download” data was recorded at 1 week, 1 and 6 months. Any changes in ventilator parameters were recorded.

Results: Of the 30 subjects, 56.7% had bulbar onset ALS, 8 died and 11 in each group completed the study. Median time to first parameter change was 33.5 (IQR:7.7-96) vs. 41 (IQR: 12.5-216.5) days for iVAPS vs. ST groups, respectively (P = 0.48). The average number of RT interventions was similar between groups (1.1±1.1 vs 0.9±0.9 at 1 month, P = 0.72; 2.4±2.1 vs 2.4±2.3 at 6 months, P = 0.95; for iVAPS vs ST respectively). Adherence was significantly lower with iVAPS than ST at 1 week, but not at 1 or 6 months. Download parameters were similar between groups at 1 week and 6 months, except for higher residual apnea-hypopnea index (AHI) and less spontaneously triggered breaths with iVAPS at 6 months.

Conclusions: The time to first change of parameters and the number of interventions at 6 months from NIV initiation were similar for the iVAPS and ST modes in subjects with ALS. With iVAPS, adherence was lower transiently at NIV initiation, and the residual AHI was higher at 6 months. Alveolar ventilation-targeted NIV may require a longer adaptation period and result in greater upper airway instability in predominantly bulbar ALS subjects.

  • noninvasive ventilation (NIV)
  • intelligent volume-assured pressure support (iVAPS)
  • bilevel spontaneous timed ventilation
  • amyotrophic lateral sclerosis (ALS)
  • respiratory therapist interventions
  • apnea hypopnea index

Footnotes

  • Address for correspondence:
    Pattaraporn Panyarath, MD, McGill University Health Centre, Respiratory Division/Sleep laboratory, 1001 Decarie Blvd, Montreal, Qc, Canada, H4A 3J1, pattaraporn.panyarath{at}mail.mcgill.ca
  • Marta Kaminska, MD, M.Sc. FRCP(C), McGill University Health Centre, Respiratory Division/Sleep laboratory, 1001 Decarie Blvd, Montreal, Qc, Canada, H4A 3J1, tel: 514–934-1934 ext 32117, fax: 514–843-1695, marta.kaminska{at}mcgill.ca
  • Received August 25, 2021.
  • Accepted February 28, 2022.
  • Copyright © 2022 by Daedalus Enterprises

Pay Per Article - You may access this article (from the computer you are currently using) for 1 day for US$30.00

Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.

Log in using your username and password

Forgot your user name or password?
PreviousNext
Back to top

In this issue

Respiratory Care: 67 (7)
Respiratory Care
Vol. 67, Issue 7
1 Jul 2022
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author

 

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Association for Respiratory Care.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Alveolar Ventilation-Targeted vs. Spontaneous/Timed Mode for Home Non-Invasive Ventilation in Amyotrophic Lateral Sclerosis
(Your Name) has sent you a message from American Association for Respiratory Care
(Your Name) thought you would like to see the American Association for Respiratory Care web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Alveolar Ventilation-Targeted vs. Spontaneous/Timed Mode for Home Non-Invasive Ventilation in Amyotrophic Lateral Sclerosis
Pattaraporn Panyarath, Veronique Adam, R John Kimoff, Marta Kaminska
Respiratory Care Mar 2022, respcare.09580; DOI: 10.4187/respcare.09580

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Alveolar Ventilation-Targeted vs. Spontaneous/Timed Mode for Home Non-Invasive Ventilation in Amyotrophic Lateral Sclerosis
Pattaraporn Panyarath, Veronique Adam, R John Kimoff, Marta Kaminska
Respiratory Care Mar 2022, respcare.09580; DOI: 10.4187/respcare.09580
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • Info & Metrics
  • References
  • PDF

Related Articles

Cited By...

Keywords

  • noninvasive ventilation (NIV)
  • intelligent volume-assured pressure support (iVAPS)
  • bilevel spontaneous timed ventilation
  • amyotrophic lateral sclerosis (ALS)
  • respiratory therapist interventions
  • apnea hypopnea index

Info For

  • Subscribers
  • Institutions
  • Advertisers

About Us

  • About the Journal
  • Editorial Board
  • Reprints/Permissions

AARC

  • Membership
  • Meetings
  • Clinical Practice Guidelines

More

  • Contact Us
  • RSS
American Association for Respiratory Care

Print ISSN: 0020-1324        Online ISSN: 1943-3654

© Daedalus Enterprises, Inc.

Powered by HighWire