Baseline characteristics of the patients.

BackgroundThis study investigates the efficacy of Intermittent Abdominal Pressure Ventilation (IAPV) and Expiratory Rib Cage Compression (ERCC) in reducing hypercapnia among critically ill, mechanically ventilated patients. It also assesses the feasibility of automating these techniques using a self-developed, ventilator-synchronized device on a dummy.MethodsThis single-arm feasibility study was conducted in two intensive care units at Charité – Universitätsmedizin Berlin, including critically ill patients with hypercapnic lung failure, with additional lab testing at the Technical University of Berlin. Manual IAPV and ERCC were applied to patients, and automation feasibility was tested on a dummy using prototype device. Primary outcomes included changes in tidal volume and partial pressure of carbon dioxide (PaCO2) and device effectiveness at different PEEP levels.ResultsIn nine hypercapnic patients, manual IAPV increased tidal volume from 5.72 to 8.85 mL/ kg predicted bodyweight (p ConclusionManual and automated ventilator-synchronized IAPV and ERCC were associated with improved ventilation. Their potential role in managing hypercapnic respiratory failure—such as in weaning failure, obstructive lung disease, or neuromuscular weakness—remains a subject for future clinical research.German Registry of Clinical Trials (DRKS00027397)