Noninvasive Ventilation and Lung Volume Reduction

Murphy, Patrick B.; Zoumot, Zaid; Polkey, Michael I.

doi:10.1016/j.ccm.2013.10.011

Cited by 6 publications

(6 citation statements)

References 94 publications

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“…Four larger well-designed RCTs have been performed using HI-NIV in patients with severe COPD [ 33 , 34 , 36 , 43 ]. In stable chronic hypercapnic patients, two studies showed quite convincing benefits although a survival benefit was only shown in one study (level B evidence) [ 33 , 34 ].…”

Section: Randomised Controlled Trials Using High-intensity Noninvasivmentioning

confidence: 99%

Noninvasive ventilation in stable hypercapnic COPD: what is the evidence?

Duiverman

2018

ERJ Open Res

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Long-term noninvasive ventilation (NIV) to treat chronic hypercapnic respiratory failure is still controversial in severe chronic obstructive pulmonary disease (COPD) patients. However, with the introduction of high-intensity NIV, important benefits from this therapy have also been shown in COPD. In this review, the focus will be on the arguments for long-term NIV at home in patients with COPD. The rise of (high-intensity) NIV in COPD and the randomised controlled trials showing positive effects with this mode of ventilation will be discussed. Finally, the challenges that might be encountered (both in clinical practice and in research) in further optimising this therapy, monitoring and following patients, and selecting the patients who might benefit most will be reviewed.

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Section: Randomised Controlled Trials Using High-intensity Noninvasivmentioning

confidence: 99%

Noninvasive ventilation in stable hypercapnic COPD: what is the evidence?

Duiverman

2018

ERJ Open Res

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“…Long-term non-invasive ventilation (NIV) has long been controversial in patients with stable Chronic Obstructive Pulmonary Disease (COPD) and chronic hypercapnic respiratory failure (CHRF) 1–7. However, with the introduction of high-intensity NIV, defined as a mode of ventilation with higher inspiratory pressures and a higher backup respiratory rate (BURR) aimed at a more controlled form of ventilation and improvement in gas exchange,8 9 clinically relevant improvements have also been shown in COPD, without undue loss of patient comfort 10–17. On the basis of these positive results, chronic NIV set up to target substantial arterial carbon dioxide reduction has become the standard of care for patients with severe stable COPD and CHRF.…”

Section: Introductionmentioning

confidence: 99%

Home initiation of chronic non-invasive ventilation in COPD patients with chronic hypercapnic respiratory failure: a randomised controlled trial

Duiverman

Vonk

Bladder

et al. 2019

Thorax

140

139

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IntroductionChronic non-invasive ventilation (NIV) has become evidence-based care for stable hypercapnic COPD patients. While the number of patients increases, home initiation of NIV would greatly alleviate the healthcare burden. We hypothesise that home initiation of NIV with the use of telemedicine in stable hypercapnic COPD is non-inferior to in-hospital NIV initiation.MethodsSixty-seven stable hypercapnic COPD patients were randomised to initiation of NIV in the hospital or at home using telemedicine. Primary outcome was daytime arterial carbon dioxide pressure (PaCO2) reduction after 6 months NIV, with a non-inferiority margin of 0.4 kPa. Secondary outcomes were health-related quality of life (HRQoL) and costs.ResultsHome NIV initiation was non-inferior to in-hospital initiation (adjusted mean difference in PaCO2 change home vs in-hospital: 0.04 kPa (95% CI −0.31 to 0.38 kPa), with both groups showing a PaCO2 reduction at 6 months compared with baseline (home: from 7.3±0.9 to 6.4±0.8 kPa (p<0.001) and in-hospital: from 7.4±1.0 to 6.4±0.6 kPa (p<0.001)). In both groups, HRQoL improved without a difference in change between groups (Clinical COPD Questionnaire total score-adjusted mean difference 0.0 (95% CI −0.4 to 0.5)). Furthermore, home NIV initiation was significantly cheaper (home: median €3768 (IQR €3546–€4163) vs in-hospital: median €8537 (IQR €7540–€9175); p<0.001).DiscussionThis is the first study showing that home initiation of chronic NIV in stable hypercapnic COPD patients, with the use of telemedicine, is non-inferior to in-hospital initiation, safe and reduces costs by over 50%.Trial registration numberNCT02652559.

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“…Risk factors for mortality in this group were age >65, severe pulmonary hypertension (PASP > 60 mmHg), prolonged cardiopulmonary bypass (CPB) and high transfusion requirements. A variety of experimental bronchoscopic lung volume reduction techniques are currently being evaluated and consideration should be given to enrollment in one of these studies for patients with less advanced disease 46 .…”

Section: Part 1: Recipient Selection and Choice Of Proceduresmentioning

confidence: 99%

A global perspective of lung transplantation: Part 1 - Recipient selection and choice of procedure

Girgis

Khaghani

2016

gcsp

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Lung transplantation has grown considerably in recent years and its availability has spread to an expanding number of countries worldwide. Importantly, survival has also steadily improved, making this an increasingly viable procedure for patients with end-stage lung disease and limited life expectancy. In this first of a series of articles, recipient selection and type of transplant operation are reviewed. Pulmonary fibrotic disorders are now the most indication in the U.S., followed by chronic obstructive pulmonary disease and cystic fibrosis. Transplant centers have liberalized criteria to include older and more critically ill candidates. A careful, systematic, multi-disciplinary selection process is critical in identifying potential barriers that may increase risk and optimize long-term outcomes.

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Noninvasive Ventilation and Lung Volume Reduction

Cited by 6 publications

References 94 publications

Noninvasive ventilation in stable hypercapnic COPD: what is the evidence?

Noninvasive ventilation in stable hypercapnic COPD: what is the evidence?

Home initiation of chronic non-invasive ventilation in COPD patients with chronic hypercapnic respiratory failure: a randomised controlled trial

A global perspective of lung transplantation: Part 1 - Recipient selection and choice of procedure

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