Respiratory failure & ventilation
End-inspiratory pause enhances ventilation efficiency without increasing autoPEEP in patients with chronic obstructive pulmonary disease (COPD) during controlled ventilation
Authors' conclusion
In sedated, mechanically ventilated patients with COPD, a strategy using high inspiratory flow with a short inspiratory pause reduces PaCO₂ and improves oxygenation without increasing auto-PEEP.
Study context
- Population
- Sedated, intubated adults with acute exacerbation of COPD, PaCO₂ ≥45 mmHg, no spontaneous respiratory effort, undergoing controlled hypoventilation
- Comparison
- VentPAUSE vs VentNO-PAUSE
- Primary endpoint
- PaCO₂ reduction without increasing hyperinflation
Methodological detailsprospective, single-centre, cross-over
- Prospective
- Single-centre
- Cross-over
Primary result
As reported in the abstract
PaCO₂
P < 0.001
Further findings
| Outcome | VentPAUSE | VentNO-PAUSE | P value |
|---|---|---|---|
| Arterial pHIncreased | 7.34 ± 0.08 | 7.31 ± 0.09 | P < 0.001 |
Ventilatory ratio
- Decreased with VentPAUSE, indicating improved ventilatory efficiency
- P < 0.001
Oxygenation (PaO₂ and PaO₂/FiO₂)
- Improved with VentPAUSE
- P < 0.05
Alveolar-to-arterial oxygen difference
- Unchanged
- P = 0.813
PaCO₂ reduction by respiratory system elastance (subgroup)
- Greater PaCO₂ reduction with higher respiratory system elastance
Safety
Total PEEP and auto-PEEP
- Not affected
- P > 0.999
Original publication
End-inspiratory pause enhances ventilation efficiency without increasing autoPEEP in patients with COPD during controlled ventilation. Crit Care. Published 10 March 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →