Noninvasive Ventilation at Home for Severe COPD?

In selected patients with acute respiratory failure, noninvasive positive pressure ventilation (NPPV) reduces the rate of intubation. But is there a role for NPPV in patients with severe but stable chronic obstructive pulmonary disease (COPD)?

To address this question, researchers enrolled 52 patients with advanced, stable COPD (mean FEV₁, 30 percent of predicted; mean PaO₂, 57 mm Hg; mean PaCO₂, 52 mm Hg). They were randomized to receive either standard care or standard care plus home nocturnal NPPV (administered nasally with a bilevel pressure ventilation system). During 1 year of follow-up, there were no significant differences between groups in mortality, hospital admissions, acute COPD exacerbations, arterial blood gas measurements, or …