Respiratory medicine
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Respiratory medicine · Oct 2003
Review Meta AnalysisNon-invasive positive pressure ventilation (NIPPV) in stable patients with chronic obstructive pulmonary disease (COPD).
While non-invasive positive pressure ventilation (NIPPV) has become an accepted management approach for patients with acute hypercapnia, it remains unclear whether it can also be beneficial in stable chronic obstructive pulmonary disease (COPD) patients with chronic respiratory failure. Randomised controlled trials (RCT) with a maximum duration of 3 months showed contradictory effects in blood gasses, dyspnoea, sleep efficiency and health-related quality of life. On the other hand, several uncontrolled trials did show positive results in patients with hypercapnia. ⋯ However, a selected group of patients might have clinical benefits from it. Patients who are clearly hypercapnic, who can tolerate an effective level of ventilatory support, and who get enough time to adjust to the ventilator might show clinical benefits even after 3 months. A trial with ventilatory support in this group of patients can be considered.