Long-term non-invasive ventilation reduces readmissions in COPD patients with two or more episodes of acute hypercapnic respiratory failure. Issue 1 (1st January 2016)

• Record Type: Journal Article
• Authors: Ankjærgaard, Kasper Linde; Maibom, Sophia Liff; Wilcke, Jon Torgny
• Is Part Of: European clinical respiratory journal. Volume 3:Issue 1(2016)
• Publication Date: 2016-01-01
• Subjects: COPD -- ventilation -- respiratory failure -- hypercapnia -- exacerbations; Lungs -- Diseases -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Lung Diseases; Lungs -- Diseases; Respiratory organs -- Diseases; Europe; Periodicals; Electronic journals; Periodicals; 616.24
• DOI: 10.3402/ecrj.v3.28303
• Languages: English
• ISSNs: 2001-8525

Abstract

Abstract : Background: Chronic obstructive pulmonary disease (COPD) patients who have had an episode of acute hypercapnic respiratory failure (AHRF) have a large 1-year risk of death or readmission. Acute non-invasive ventilation (NIV) has been shown to be an effective treatment of AHRF; and long-term NIV (LTNIV) has been shown to be an effective treatment of chronic respiratory failure in stable hypercapnic COPD. We investigated the effects of LTNIV in a group of patients with severe, unstable COPD: frequent admissions and multiple previous episodes of AHRF treated with NIV. Methods: We conducted a retrospective analysis of 20 COPD patients treated with LTNIV after two or more episodes of AHRF during 1 year. Results: The mean number of AHRF episodes decreased from 2.44 in the year prior to LTNIV initiation to 0.44 in the year following ( p< 0.0001). The median number of admissions decreased from 5.19 to 1.88 ( p= 0.0092). Four patients (20%) died in 1 year. LTNIV tended to reduce arterial CO2 . No changes were found in lung function. Conclusions: LTNIV seems effective in reducing recurrent AHRF and readmissions in a highly select group of patients with severe, unstable COPD and frequent AHRF.