What is your approach to selecting and adjusting NIPPV settings in the management of patients with chronic hypercapnic respiratory failure?  

In our clinic, which serves more patients with neuromuscular disease and advanced lung disease than OHS, most of our patients that have already developed hypercapnic respiratory failure have advanced lung disease or are the survivors of critical illness. We are hopefully catching patients with neuro...

For chronic hypercapnic respiratory failure, we determine the etiology (severe COPD, OHS, or neuromuscular weakness). We also screen for concomitant OSA. We order AVAPS for these patients and follow up on their response with daytime ABG clinical response.

I agree in general with previous comments, but it is well to keep in mind that AVAPS (average volume-assured pressure support) and iVAPS (intelligent VAPS) are proprietary terms of Philips Respironics and ResMed, respectively, and that AVAPS has limited availability as Philips has stopped manufactur...