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IPAP is adjusted for each inspiration with a goal to maintain a moving target ventilation set at 90% of the patient's recent average minute ventilation.
Another algorithm uses prior peak flows to target the level of IPAP.
The aim is to stabilize breathing and reduce respiratory alkalosis which can trigger apnea re-entry cycles which are often part of the pathogenesis of those disorders.
Volume-assured pressure support is predominantly used in patients with chronic hypoventilation such as those with the OHS, neuromuscular diseases and COPD.
Thus, numerous modes of noninvasive ventilation are available, each with a proprietary brand name.
The literature is plagued with different names and acronyms to refer to the same mode of ventilation (Table 1).
That is, we can use a pressure or volume-controlled mode (both generate positive pressure) to deliver ventilation.The next level of sophistication is the administration of two different levels of pressure, one for inspiration and one for the expiratory phase.As technology has advanced, so have the devices and the techniques that control how the delivery of pressure (mechanical breaths) are started (triggered), controlled (targeted), and ended (cycled).Thus, the basic concept of NIPPV is the application of positive pressure during the respiratory cycle (inspiration and expiration).The simplest application is that of continuous positive pressure through the respiratory cycle, which is named CPAP.