NIV in treating COPD

Recent studies have shown that home non-invasive ventilation (NIV) using adequate pressure support in stable hypercapnic COPD patients can reduce the number of hospitalisations and improve mortality.1

The publication of a ground‐breaking study in The Lancet Respiratory Medicine found patients with chronic stable COPD who were assigned to home NIV treatment had improved survival and quality of life.1

The trial of 195 patients with stable GOLD stage IV COPD on standard therapy randomised patients to a control group or to NIV therapy targeted to reduce baseline PaCO₂ by 20% or more, or achieve PaCO₂ values lower than 6.5kPa (48.1mm Hg).

Results showed that NIV using adequate pressure support resulted in a one‐year mortality rate of 11.8% in the NIV group compared to 33.3% in the control group (HR 0.24%, CI 0.11‐0.49; p=0.0004).1

Patients who were randomised to NIV therapy at home also had a significant improvement in Health Related Quality of Life, as measured by the globally recognised St George’s Respiratory Questionnaire summary score.1

This latest data adds to a growing body of evidence showing that stable hypercapnic COPD patients can significantly benefit from NIV, particularly if an improvement in baseline PaCO₂ is the clinical target.1 2

A retrospective study of hospitalised hypercapnic patients with COPD found those given NIV therapy after discharge had improved event‐free survival (p=<0.0001) compared to similar patients not treated with NIV. Patients who received NIV therapy were also less likely to be re‐admitted to hospital compared to non‐treated patients (40% vs 75% p=<0.0001).3

References

  • 01

    Koehnlein, T et al. Non‐invasive positive pressure ventilation for the treatment of severe, stable chronic obstructive pulmonary disease: a prospective, multicentre, randomised, controlled clinical trial. Lancet Resp Med 2014;2:698‐705.

  • 02

    Mark Elliott, Domiciliary NIV for COPD: where are we now? Lancet Resp Med 2014;2:672‐673.

  • 03

    Galli, J Krakhne, J. et al. Respiratory Medicine 2014; 108:722‐728.

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