1. Improved survival for COPD patients
In a recent prospective, randomised controlled trial (Köhnlein et al. 2014), clinicians studied the use of home-based non-invasive ventilation compared to standard therapy for patients with stable hypercapnic COPD.
After a follow-up period of 12 months, the risk of mortality was 76% lower in the intervention group compared to the control group. Improvements were also reported for patient quality of life and exercise tolerance.8
Reduction in mortality in hypercapnic COPD patients on non-invasive ventilation therapy
Kaplan-Meier estimate of cumulative all-cause mortality during the first year after randomisation. Adapted from Köhnlein et al. 2014.
2. Clinical benefits for nocturnal non-invasive ventilation at home
A 2-year study (Duiverman et al. 2011) has demonstrated various clinical benefits for adding non-invasive ventilation to COPD treatment at home compared to pulmonary rehabilitation alone. The study reported improvements to the following outcomes, with benefits also increasing over time:
- Health-related quality of life and mood
- Arterial blood gas exchange
- Exercise tolerance and activity levels
- Lung function, including FEV1.10
3. Home non-invasive ventilation reduces hospital readmissions
A retrospective study (Galli et al. 2014) assessed the outcomes for patients who were prescribed non-invasive ventilation at home compared to those who were not prescribed non-invasive ventilation.
Analysed data showed that patients who had been prescribed non-invasive ventilation at discharge were less likely to have been readmitted to hospital or readmitted with a stay in the intensive care unit.7
Effect of prior home non-invasive ventilation on event-free survival following readmission
Kaplan-Meier curves of event-free survival comparing patients who used home non-invasive ventilation versus patients who did not use home non-invasive ventilation. Adapted from Galli et al. 2014.
4. Home non-invasive ventilation reduces the probability of recurrent respiratory failure
A pilot trial (Cheung et al. 2010 ) observed that COPD patients with acute hypercapnic respiratory failure (AHRF) were less likely to experience a recurrent severe exacerbation when treated with non-invasive ventilation compared to treatment with continuous positive airway pressure (CPAP). The prevalence of patients developing recurrent AHRF in the non-invasive ventilation group compared to the CPAP group was 38.5% to 60.2% at 1 year.11
Effect of CPAP vs. non-invasive ventilation on patients with AHRF
Kaplan-Meier curves showing reduced rate of recurrent AHRF in COPD patients given home non-invasive ventilation compared with patients given CPAP. Adapted from Cheung et al. 2010.