Home non-invasive ventilation use following acute hypercapnic respiratory failure in COPD

Respir Med. 2014 May;108(5):722-8. doi: 10.1016/j.rmed.2014.03.006. Epub 2014 Mar 20.


Rationale: Patients with COPD and hypercapnic respiratory failure have a worse prognosis and experience a faster deterioration in their pulmonary function. The benefit of home NPPV following an acute exacerbation of COPD with hypercapnic respiratory failure is not well understood.

Objectives: To evaluate the effect of home NPPV use in patients following a hospitalization for AECOPD with acute hypercapnic respiratory failure on event-free survival after an index admission.

Methods: We conducted a retrospective, single-center, chart review on patients hospitalized in 2011 with a diagnosis of AECOPD, hypercapnia, and used NPPV during hospitalization. 166 patients were included and were divided into two groups: patients who used NPPV post discharge and patients who did not.

Results: Patients in the NPPV post discharge group demonstrated superior event-free survival compared to the no-NPPV post discharge group (y2 = 23.8, p < 0.0001). The NPPV post discharge group had a statistically significant reduction in hospital readmissions (40% versus 75%, p < 0.0001) through 180 days from the index admission.

Conclusions: Patients who used NPPV following an admission for AECOPD with hypercapnic respiratory failure had lower readmission rates and improved event-free survival after 180 days from an index admission compared to patients who did not use NPPV post discharge.

Keywords: BIPAP; COPD; Hypercapnia; Non-invasive positive pressure ventilation; Non-invasive ventilation; Respiratory failure.

Publication types

  • Evaluation Study

MeSH terms

  • Acute Disease
  • Aged
  • Disease-Free Survival
  • Female
  • Home Care Services, Hospital-Based*
  • Hospitalization
  • Humans
  • Hypercapnia / etiology
  • Hypercapnia / therapy
  • Intensive Care Units / statistics & numerical data
  • Intubation, Intratracheal
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Noninvasive Ventilation / methods*
  • Patient Readmission / statistics & numerical data
  • Philadelphia
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • Respiratory Insufficiency / etiology
  • Respiratory Insufficiency / therapy*
  • Retrospective Studies