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Abstract Average volume-assured pressure support (AVAPS) is one of those newly developed modes. AVAPS is a mode of NIV that estimates the patient’s VT over several breathes and calculates the variations in inspiratory positive airway pressure (IPAP) needed to achieve the patient’s target VT aiming for patient safety and comfort. This study is a prospective observational randomized (by closed envelops) study that included 40 patients who were divided into 2 groups: •group I: 20 patients received BIPAP spontaneous/timed (ST) mode •group II: 20 patients received BIPAP (AVAPS) mode. Inclusion criteria: Patients with BMI>30 kg/m2, daytime hypercapnea (PaCO2 ≥45mmHg) and have failed to respond to CPAP therapy, with no other causes for chronic respiratory failure. Exclusion criteria: 1. CPAP responders: Patients with OHS who respond to CPAP therapy for one month. 2. Patients with acute respiratory failure (respiratory rate >30 breath /min and PH <7.25 or glascow coma score (GCS)<8) who require invasive ventilation . 3. Patients who are switched from invasive ventilation to non invasive positive pressure ventilation as a form of weaning from ventilatory support during the last 3 months. |