title: Volume-targeted versus pressure-targeted noninvasive ventilation in patients with chest-wall deformity: a pilot study.
abstract: BACKGROUND
  Long-term noninvasive ventilation (NIV) is an effective treatment for patients with chronic respiratory failure due to chest-wall deformity, but it is unknown if the time required for the patient to adjust to long-term NIV depends on whether the NIV is volume-targeted or  pressure-targeted.
  
  
  OBJECTIVE
  To determine whether volume controlled or pressure controlled NIV is easier to implement in patients with chronic respiratory failure due to chest-wall deformity.
  
  
  METHODS
  We randomized 16 ventilator-naïve patients to receive either volume-targeted or pressure-targeted  nocturnal NIV. The primary outcome was the number of days needed to successfully establish NIV, defined as adequate adjustment and effective ventilation, as measured with overnight arterial blood gas measurement.
  
  
  RESULTS
  Two patients did not tolerate volume NIV, and switched to pressure NIV.  NIV was successfully established in both groups after a median 6.0 days. There were no significant differences between the groups at any time point in P(aCO(2)) or P(aO(2)) improvement, nor in changes over time.
  
  
  CONCLUSIONS
  There was no significant difference  in days needed to successfully establish volume NIV versus pressure NIV in patients with chest-wall deformity. However, two patients switched successfully from volume NIV to pressure NIV, which suggests that they preferred pressure NIV.
authors.affiliation: Department of Pulmonary Diseases and Home Mechanical Ventilation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. f.m.struik@umcg.nl
authors.forename: Fransien M
authors.initials: FM
authors.lastname: Struik
authors.forename: Marieke L
authors.initials: ML
authors.lastname: Duiverman
authors.forename: Petra M
authors.initials: PM
authors.lastname: Meijer
authors.forename: Jellie A
authors.initials: JA
authors.lastname: Nieuwenhuis
authors.forename: Huib Am
authors.initials: HA
authors.lastname: Kerstjens
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Wijkstra
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011175:Positive-Pressure Respiration / Q000379:methods*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D035441:Thoracic Wall / Q000002:abnormalities*