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

Jonathan A Galli, Jason S Krahnke, A James Mamary, Kartik Shenoy, Huaqing Zhao, Gerard J Criner
Respiratory Medicine 2014, 108 (5): 722-8

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.

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