Nocturnal Noninvasive Positive Pressure Ventilation Might Prevent Some COPD Exacerbations

Readmissions of patients with chronic obstructive pulmonary disease (COPD) after hospitalization for exacerbations is a hot topic. At discharge, nocturnal noninvasive positive pressure ventilation (NPPV) sometimes is prescribed for home use with goals of decreasing the work of breathing, improving hypercarbia, and avoiding recurrent exacerbations. However, in previous small trials, patients have not benefited from this intervention.

Investigators in the U.K. identified 116 patients with very-severe COPD (mean forced expiratory volume in 1 second, 23% of predicted) and recent exacerbations (within 4 weeks) who exhibited persistent hypoxemia (mean arterial partial pressure of oxygen [PaO₂], 48 mm Hg) and hypercarbia (mean arterial partial pres…