Disposable vs. conventional NPPV in acute respiratory acidosis

Abstract

Objectives: Acute respiratory acidosis requires ventilatory support. Noninvasive positive pressure ventilation (NPPV) may be delayed in crowded emergency settings. Disposable systems may offer advantages, but evidence remains limited.

Methods: This prospective, single-center observational study included adults with acute respiratory acidosis requiring NPPV from September 2024 to April 2025. Patients received conventional ventilator-based NPPV or a disposable oxygen-driven bilevel CPAP/NPPV system according to clinician decision. The primary outcome was 60-min arterial pH; secondary outcomes included physiological responses, intubation, and 24-h mortality.

Results: Of 323 screened patients, 204 were analyzed: 100 conventional and 104 disposable-system patients. After adjustment for baseline imbalances, 60-min arterial pH did not differ significantly between groups; HC3 robust-standard-error and BCa-bootstrap sensitivity analyses gave the same inference. Intubation and 24-h mortality were similar. Exploratory longitudinal analyses suggested improvement in pH and PaCO2, but these findings were hypothesis-generating.

Conclusions: Because device allocation was not randomized and the groups differed at baseline in disease-severity variables, these data do not support a reliable efficacy comparison between the two systems and should not be interpreted as evidence of equivalence or superiority. Larger randomized or rigorously controlled studies are needed to clarify the role of disposable noninvasive ventilation in acute hypercapnic respiratory acidosis.

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Cite

BibTeX RIS

BibTeX

@article{demir2026disposable,
  title = {{Disposable vs. conventional NPPV in acute respiratory acidosis}},
  author = {Ertugrul Demir and Meltem Songur Kodik and Ozlem Inci and Ilhan Uz and Mehmet Birkan Korgan},
  journal = {Open Medicine},
  year = {2026},
  month = nov,
  doi = {10.1515/med-2026-1563},
  url = {https://europepmc.org/article/PMC/PMC13726665},
  note = {CC BY},
}

RIS

TY  - JOUR
TI  - Disposable vs. conventional NPPV in acute respiratory acidosis
AU  - Ertugrul Demir
AU  - Meltem Songur Kodik
AU  - Ozlem Inci
AU  - Ilhan Uz
AU  - Mehmet Birkan Korgan
PY  - 2026
DA  - 2026/11/02
JO  - Open Medicine
DO  - 10.1515/med-2026-1563
UR  - https://europepmc.org/article/PMC/PMC13726665
AB  - Objectives: Acute respiratory acidosis requires ventilatory support. Noninvasive positive pressure ventilation (NPPV) may be delayed in crowded emergency settings. Disposable systems may offer advantages, but evidence remains limited.  Methods: This prospective, single-center observational study included adults with acute respiratory acidosis requiring NPPV from September 2024 to April 2025. Patients received conventional ventilator-based NPPV or a disposable oxygen-driven bilevel CPAP/NPPV system according to clinician decision. The primary outcome was 60-min arterial pH; secondary outcomes included physiological responses, intubation, and 24-h mortality.  Results: Of 323 screened patients, 204 were analyzed: 100 conventional and 104 disposable-system patients. After adjustment for baseline imbalances, 60-min arterial pH did not differ significantly between groups; HC3 robust-standard-error and BCa-bootstrap sensitivity analyses gave the same inference. Intubation and 24-h mortality were similar. Exploratory longitudinal analyses suggested improvement in pH and PaCO2, but these findings were hypothesis-generating.  Conclusions: Because device allocation was not randomized and the groups differed at baseline in disease-severity variables, these data do not support a reliable efficacy comparison between the two systems and should not be interpreted as evidence of equivalence or superiority. Larger randomized or rigorously controlled studies are needed to clarify the role of disposable noninvasive ventilation in acute hypercapnic respiratory acidosis.
SN  - 1911-2092
SN  - 2391-5463
ER  -

Abstract

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