Home Noninvasive Positive-Pressure Ventilation Might Benefit COPD Patients with Chronic Hypercarbia

A large body of evidence supports use of noninvasive positive-pressure ventilation (NPPV) for patients admitted to the hospital for exacerbations of chronic obstructive pulmonary disease (COPD). The data on home use of nighttime NPPV for chronic hypercarbia caused by COPD are less clear.

Investigators performed a meta-analysis of 33 studies (21 randomized, controlled trials; 12 observational studies) that involved more than 50,000 patients with chronic hypercarbia. When compared with no respiratory support, home NPPV was associated with lower risk for mortality and intubation. Fewer patients who received NPPV were admitted to the hospital (for any reason). The effect on mortality was seen when NPPV was started in patients with stable COPD bu…