U.S. flag

An official website of the United States government

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Dretzke J, Blissett D, Dave C, et al. The cost-effectiveness of domiciliary non-invasive ventilation in patients with end-stage chronic obstructive pulmonary disease: a systematic review and economic evaluation. Southampton (UK): NIHR Journals Library; 2015 Oct. (Health Technology Assessment, No. 19.81.)

Cover of The cost-effectiveness of domiciliary non-invasive ventilation in patients with end-stage chronic obstructive pulmonary disease: a systematic review and economic evaluation

The cost-effectiveness of domiciliary non-invasive ventilation in patients with end-stage chronic obstructive pulmonary disease: a systematic review and economic evaluation.

Show details

Appendix 6Details of non-invasive ventilation used in studies included in clinical effectiveness review

TABLE 59

Non-invasive ventilation used in RCTs

AuthorMaskTargetIPAP (cmH2O)EPAP (cmH2O)NIV kit
Bhatt et al. 201383Full facePressureTitrated to final pressure of 15Titrated to final pressure of 5BiPAP® Synchrony Ventilator (Respironics Inc, Murrysville, PA, USA)
Casanova et al. 200085NasalPressureAt least 8 targeted, mean achieved 12 (SD 2)At least 4 targeted (minimum of 4 achieved)DP-90 (Bilevel pressure ventilation system) (Taema, Antony Cedex, France)
Cheung et al. 201090No detailsVolume10–20 (as tolerated to target a tidal volume of 7–10 ml/kg)5 at startBiPAP® Synchrony® (Respironics Inc, Murrysville, PA, USA)
Clini et al. 200299NasalPressureSet at maximum tolerated, average 14 (SD 3)Set in range of 2–5, average 2 (SD 1)BiPAP® ST30® ‘Auto-Trak’™ ventilator (Respironics Inc, Murrysville, PA, USA, distributed in Italy by Markos-Mefar, Air Liquide Group)
De Backer et al. 201191Full faceBlood gases‘Modes were adapted until O2 saturation was > 90% during 90% of the time and PaCO2 was decreased 5% in 1 hour’91‘Modes were adapted until O2 saturation was > 90% during 90% of the time and PaCO2 was decreased 5% in 1 hour’91BiPAP® Synchrony® device (Respironics, Inc, Murrsville, PA, USA)
Duiverman et al. 200879Nasal (30%) or full face (70%)Blood gasesUp to maximal tolerated pressure titrated towards an optimal correction of nocturnal arterial blood gases [mean 20 (SD 4) in completers and 18 (SD 1) in dropouts]EPAP titrated on patient comfort. Mean 6 (SD 2) in completers and 5 (SD 1) in dropoutsBiPAP® spontaneous/timed mode (Respironics, Inc., Murrysville, PA, USA) (no further details)
Duiverman et al. 201180One patient with nasal mask, remaining with full-face maskBlood gases23 (SD 4) at start of study6 (SD 2) at start of studyBiPAP® Synchrony® (Respironics, Inc., Murrysville, PA, USA)
Garrod et al. 200084NasalPressureMedian 16 (range 13–24)Median 4 (range 4–6)BiPAP® ST30® ventilator (Respironics, Inc., Murrysville, PA, USA)
Gay et al. 1996100NasalPressure10 (target level)2 (lowest possible)BiPAP® (Respironics, Inc., Murrysville, PA, USA)
Kaminski et al. 1999101NasalBlood gasesSettings adjusted to decrease PaCO2, to increase SaO2 > 90% and to obtain maximum comfort for patientsSettings adjusted to decrease PaCO2, to increase SaO2 > 90% and to obtain maximum comfort for patientsMonnal D ventilator (Air Liquide Medical Systems, Antony,France)
Köhnlein et al. 201476Face or nasal mask according to judgement of investigatorBlood gasesMean 21.6 (SD 4.7)Mean 4.8 (SD 1.6)Ventilators marketed post 2004 (ResMed, Martinsried, Germany; Weinmann, Hamburg, Germany; or Tyco Healthcare Neuburg, Germany)
McEvoy et al. 200974Choice of nasal or full-face mask and humidificationPressureGradually increased to maximum tolerated (target of IPAP–EPAP difference of 10 or greater)Lowest possible level (approximately 3)VPAP™ S mode (ResMed, Sydney, Australia)
Meecham-Jones et al. 199577NasalPressureMedian 18 (range 16–22)Median 2 (none exceeding 4)BiPAP® in S mode (Respironics, Inc., Murrysville, PA)
Murphy et al. 201178No detailsPressureDischarge setting 26 (SD 3)Discharge setting 5 (SD 1)No details
Sin et al. 200782Choice of nasal or full-face maskPressurePatients started on 8, then titrated up until the highest tolerated level or 20 was reached (whichever came first)Set at 4VPAP II™ with heated humidifier (HumidAire, ResMed, Martinsried, Germany)
Struik et al. 201475Full-face maskPressureMean 19.2 (SD 3.4) at dischargeMean 4.8 (SD 1.0) at dischargeBiPaP® Synchrony, (Respironics Inc., Murrysville, PA, USA)
Strumpf et al. 199135Nasal maskBlood gasesSufficient to maintain PETCO2 at least 5 mmHg below the spontaneous resting level. Mean 15 (SD 1) in completersSet at 2 (lowest possible)BiPaP® ventilator (Respironics, Inc.)
Xiang et al. 200792NasalPressure16–20 at start then adjusted to patient2–4 at start then adjusted to patientBiPAP® (Hoffrichter GmbH, Schwerin, Germany, or US-based company – unable to translate)
Zhou et al. 200881Full-face maskPressureMean 12–16Mean 2–4BiPAP® (Respironics, Inc., Murrysville, PA)

PETCO2, partial pressure of exhaled carbon dioxide; SaO2, saturation of oxygen in the arterial blood.

TABLE 60

Non-invasive ventilation used in controlled non-randomised studies

AuthorMaskTargetIPAP (cmH2O)EPAP (cmH2O)NIV kit
Budweiser et al. 200796Nasal, full face or custom madeBlood gasesMean 21 (SD 4)Mean 4.5 (SD 1.4)Twin Air® (Airox Inc., Pau, France) (13/99), Smart Air® (Airox Inc., Pau, France) (14/99) or BiPAP® Synchrony ST® devices (Respironics Inc., Murrysville, PA) (51/99) or other
Clini et al. 199893NasalVolumeMinimal pressure to achieve an expiratory tidal volume > 8 ml/kg (range 10–16 ml/kg)Set in order not to overcome the supposed intrinsic positive expiratory pressure (range 2–4)BiPAP® (Respironics, Inc., Murrysville, PA, USA)
Clini et al. 199694NasalVolumeMinimal pressure to achieve an expiratory tidal volume > 8 ml/kg (range 10–16)Range 0–2BiPAP® (Respironics, Inc., Murrysville, PA, USA)
Heinemann et al. 201197Nasal, oronasal or individualBlood gasesMean 22.7 (SD 4.3) mbar (= 23.15 cmH2O)Mean 5 (SD 1.3) mbar (= 5.1 cmH2O)No details
Laier-Groeneveld and Criee 199588Nasal or oronasalBlood gasesTo achieve adequate pO2No detailsNo details
Lu et al. 201298No detailsBlood gasesMean 18.0 (SD 2.0)Mean 5.0 (SD 1.0)BiPAP® Harmony (Respironics, Inc., Murrysville, PA, USA)
Milane and Jonquet 198586No detailsNo detailsNo detailsNo detailsBird® Mark 1, Bird® Mark 7, Portabird (Bird Products Corporation, Palm Springs, CA, USA)
Pahnke et al. 199787No detailsNo detailsNo detailsNo detailsNo details
Paone et al. 201489Nasal or full-face maskVolumeMaximum inspiration pressure value tolerated by patients, able to ensure an exhaled tidal volume of 6 ml/kg (measured body weight)Between 2 and 8 cmH2ONeftis (Linde, Munich, Germany) or Synchrony (Philips Respironics, Andover MA, USA)
Tsolaki et al. 200895Full facePressureAdjusted according to patient’s comfort and synchrony with the ventilator and a marked reduction in use of accessory musclesAdjusted according to patient’s comfort and synchrony with the ventilator and a marked reduction in use of accessory musclesVPAP™ III ST (ResMed, Sydney, Australia)

TABLE 61

Different types of NIV being compared in RCTs

AuthorMaskTargetIPAP (cmH2O)EPAP (cmH2O)NIV kit
Murphy et al. 2012113Nasal or oronasalPressureMean 29 (SD 2)Mean 5 (SD 3)NIPPY3, NIPPY3 + (B&D ElectroMedical, Warwickshire, UK)
Dreher et al. 201032Nasal or oronasalBlood gasesMean 14.6 (SD 0.8) low intensity, mean 28.6 (SD 1.9) high intensity (mbar)Mean 4.0 (SD 0) low intensity, mean 4.5 (SD 0.7) high intensity (mbar)VIVO 40 (Breas Medical AB, Molnlycke, Sweden) or modified Smart Air® (Airox, Pau Cedex, France). Two patients used passive humidification
Oscroft et al. 2010112Unclear if nasal or full-face maskPressureVa-NIV set to enable adjustment of inspiratory pressure up to 25, the maximum possible with this ventilator; pp-NIV set at similar pressure settings that the subject had previously usedSettings that the patients had previously usedVa-NIV: iVAPs (ResMed, Bella Vista, Australia); pp-NIV: VPAP™ III STA (ResMed, Bella Vista, Australia)

iVAPs, intelligent Volume-Assured Pressure Support; pp, pressure preset; va, volume assured.

Copyright © Queen’s Printer and Controller of HMSO 2015. This work was produced by Dretzke et al. under the terms of a commissioning contract issued by the Secretary of State for Health. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.

Included under terms of UK Non-commercial Government License.

Bookshelf ID: NBK321569
Contents

Views

  • PubReader
  • Print View
  • Cite this Page
  • PDF version of this title (2.6M)

Other titles in this collection

Recent Activity

ClearTurn OffTurn On

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...