Consider Early Extubation to Noninvasive Ventilation in Patients with Chronic Obstructive Pulmonary Disease

Invasive mechanical ventilation is associated with ventilator-associated pneumonia and longer intensive care unit (ICU) stays. In an effort to shorten duration of invasive ventilation, researchers have conducted multiple studies to examine the effects of early extubation directly to noninvasive positive pressure ventilation (NPPV). In an update of a prior review (Cochrane Database of Systematic Reviews 2013; 12:CD004127), researchers analyzed data from 16 randomized, controlled trials (994 patients) in which NPPV was evaluated for weaning patients from invasive ventilation; 9 trials exclusively involved patients with chronic obstructive pulmonary disease (COPD), and 7 trials involved mixed populations.

Overall, risk for death was significant…