Long-term Non-invasive Ventilation Reduces Readmissions in COPD Patients with Two or More Episodes of Acute Hypercapnic Respiratory Failure

Overview

Journal Eur Clin Respir J

Specialty Pulmonary Medicine

Date 2016 Apr 3

PMID 27036658

Citations 7

Authors

Kasper Linde Ankjaergaard

Sophia Liff Maibom

Jon Torgny Wilcke

Affiliations

Soon will be listed here.

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.

Citing Articles

Long-term non-invasive ventilation for COPD patients following an exacerbation with acute hypercapnic respiratory failure: a randomized controlled trial.

Hedsund C, Linde Ankjaergaard K, Peick Sonne T, Tonnesen P, Hansen E, Andreassen H Eur Clin Respir J. 2023; 10(1):2257993.

PMID: 37746028 PMC: 10512815. DOI: 10.1080/20018525.2023.2257993.

Greek Guidelines for the Management of COPD, a Proposal of a Holistic Approach Based on the needs of the Greek Community.

Tzanakis N, Kosmas E, Papaioannou A, Hillas G, Zervas E, Loukides S J Pers Med. 2022; 12(12).

PMID: 36556218 PMC: 9788491. DOI: 10.3390/jpm12121997.

High-pressure NIV for acute hypercapnic respiratory failure in COPD: improved survival in a retrospective cohort study.

Hedsund C, Nilsson P, Hoyer N, Rasmussen D, Holm C, Peick Sonne T BMJ Open Respir Res. 2022; 9(1).

PMID: 35728841 PMC: 9214373. DOI: 10.1136/bmjresp-2022-001260.

The Effects of Low Pressure Domiciliary Non-Invasive Ventilation on Clinical Outcomes in Patients with Severe COPD Regardless Having Hypercapnia.

Theunisse C, Ponssen H, de Graaf N, Scholten-Bakker M, Willemsen S, Cheung D Int J Chron Obstruct Pulmon Dis. 2021; 16:817-824.

PMID: 33814905 PMC: 8009340. DOI: 10.2147/COPD.S289099.

Improvement in hypercapnia does not predict survival in COPD patients on chronic noninvasive ventilation.

Raveling T, Bladder G, Vonk J, Nieuwenhuis J, Verdonk-Struik F, Wijkstra P Int J Chron Obstruct Pulmon Dis. 2018; 13:3625-3634.

PMID: 30464445 PMC: 6219270. DOI: 10.2147/COPD.S169951.

References

Diaz O, Begin P, Torrealba B, Jover E, Lisboa C . Effects of noninvasive ventilation on lung hyperinflation in stable hypercapnic COPD. Eur Respir J. 2002; 20(6):1490-8. DOI: 10.1183/09031936.02.00034402. View

Simonds A . Recent advances in respiratory care for neuromuscular disease. Chest. 2006; 130(6):1879-86. DOI: 10.1378/chest.130.6.1879. View

de Leeuw P, Dees A . Fluid homeostasis in chronic obstructive lung disease. Eur Respir J Suppl. 2003; 46:33s-40s. DOI: 10.1183/09031936.03.00000603a. View

De Backer L, Vos W, Dieriks B, Daems D, Verhulst S, Vinchurkar S . The effects of long-term noninvasive ventilation in hypercapnic COPD patients: a randomized controlled pilot study. Int J Chron Obstruct Pulmon Dis. 2011; 6:615-24. PMC: 3224655. DOI: 10.2147/COPD.S22823. View

Budweiser S, Jorres R, Riedl T, Heinemann F, Hitzl A, Windisch W . Predictors of survival in COPD patients with chronic hypercapnic respiratory failure receiving noninvasive home ventilation. Chest. 2007; 131(6):1650-8. DOI: 10.1378/chest.06-2124. View

Funk G, Breyer M, Burghuber O, Kink E, Kirchheiner K, Kohansal R . Long-term non-invasive ventilation in COPD after acute-on-chronic respiratory failure. Respir Med. 2010; 105(3):427-34. DOI: 10.1016/j.rmed.2010.09.005. View

Garrod R, Mikelsons C, Paul E, Wedzicha J . Randomized controlled trial of domiciliary noninvasive positive pressure ventilation and physical training in severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2000; 162(4 Pt 1):1335-41. DOI: 10.1164/ajrccm.162.4.9912029. View

Casanova C, Celli B, Tost L, Soriano E, Abreu J, Velasco V . Long-term controlled trial of nocturnal nasal positive pressure ventilation in patients with severe COPD. Chest. 2000; 118(6):1582-90. DOI: 10.1378/chest.118.6.1582. View

Elliott M, Mulvey D, Moxham J, Green M, Branthwaite M . Domiciliary nocturnal nasal intermittent positive pressure ventilation in COPD: mechanisms underlying changes in arterial blood gas tensions. Eur Respir J. 1991; 4(9):1044-52. View

10.

Clini E, Sturani C, Porta R, Scarduelli C, Galavotti V, Vitacca M . Outcome of COPD patients performing nocturnal non-invasive mechanical ventilation. Respir Med. 1999; 92(10):1215-22. DOI: 10.1016/s0954-6111(98)90424-3. View

11.

Kohnlein T, Windisch W, Kohler D, Drabik A, Geiseler J, Hartl S . Non-invasive positive pressure ventilation for the treatment of severe stable chronic obstructive pulmonary disease: a prospective, multicentre, randomised, controlled clinical trial. Lancet Respir Med. 2014; 2(9):698-705. DOI: 10.1016/S2213-2600(14)70153-5. View

12.

Tang C, Taylor N, Blackstock F . Chest physiotherapy for patients admitted to hospital with an acute exacerbation of chronic obstructive pulmonary disease (COPD): a systematic review. Physiotherapy. 2010; 96(1):1-13. DOI: 10.1016/j.physio.2009.06.008. View

13.

Chu C, Chan V, Lin A, Wong I, Leung W, Lai C . Readmission rates and life threatening events in COPD survivors treated with non-invasive ventilation for acute hypercapnic respiratory failure. Thorax. 2004; 59(12):1020-5. PMC: 1746916. DOI: 10.1136/thx.2004.024307. View

14.

Struik F, Sprooten R, Kerstjens H, Bladder G, Zijnen M, Asin J . Nocturnal non-invasive ventilation in COPD patients with prolonged hypercapnia after ventilatory support for acute respiratory failure: a randomised, controlled, parallel-group study. Thorax. 2014; 69(9):826-34. DOI: 10.1136/thoraxjnl-2014-205126. View

15.

Hurst J, Vestbo J, Anzueto A, Locantore N, Mullerova H, Tal-Singer R . Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med. 2010; 363(12):1128-38. DOI: 10.1056/NEJMoa0909883. View

16.

Jones S, Packham S, Hebden M, Smith A . Domiciliary nocturnal intermittent positive pressure ventilation in patients with respiratory failure due to severe COPD: long-term follow up and effect on survival. Thorax. 1998; 53(6):495-8. PMC: 1745247. DOI: 10.1136/thx.53.6.495. View

17.

ROCHESTER D, Arora N, Braun N, Goldberg S . The respiratory muscles in chronic obstructive pulmonary disease (COPD). Bull Eur Physiopathol Respir. 1979; 15(5):951-75. View

18.

Budweiser S, Hitzl A, Jorres R, Heinemann F, Arzt M, Schroll S . Impact of noninvasive home ventilation on long-term survival in chronic hypercapnic COPD: a prospective observational study. Int J Clin Pract. 2007; 61(9):1516-22. DOI: 10.1111/j.1742-1241.2007.01427.x. View

19.

Donaldson G, Mullerova H, Locantore N, Hurst J, Calverley P, Vestbo J . Factors associated with change in exacerbation frequency in COPD. Respir Res. 2013; 14:79. PMC: 3733814. DOI: 10.1186/1465-9921-14-79. View

20.

Mullerova H, Maselli D, Locantore N, Vestbo J, Hurst J, Wedzicha J . Hospitalized exacerbations of COPD: risk factors and outcomes in the ECLIPSE cohort. Chest. 2014; 147(4):999-1007. DOI: 10.1378/chest.14-0655. View