The addition of noninvasive ventilation to home oxygen and standard care following an exacerbation of COPD can reduce the risk of hospital readmission or death.
A multi-centre UK study recruited 116 patients with persistent hypercapnia (PaCO2 >53mmHg) and hypoxaemia (PaO2 <55mmHg) two to four weeks after an initial exacerbation.
The study, presented at the American Thoracic Society International Conference in Washington last week, found the addition of non-invasive ventilation (NIV) extended the time to readmission or death from 1.4 to 4.3 months.
Ventilation also reduced the number of exacerbations from 5.1 to 3.8 per year and the absolute risk of readmission or deaths in 12 months by 17%.
Health-related quality of life improved with ventilation but only at the 6-week and 3-month time points. All-cause mortality did not differ significantly between the ventilated and non-ventilated groups.
Commenting on the study, Professor Christine McDonald said the findings were of interest for the small number of COPD patients with severe end-stage disease and recurrent hospitalisations requiring non-invasive ventilation.
“More than 50% of the patients in this pragmatic UK study had at least three COPD-related admissions in the past year so they were recurrent presenters and a very severe group. The study provides a little support for home NIV in that situation,” she told the limbic in an interview.