Abstract
Introduction
Nocturnal non-invasive positive pressure ventilation (NIPPV) might be beneficial in stable hypercapnic patients with COPD. However, evidence remains conflicting.
Aim
To determine the effect of NIPPV in patients with stable hypercapnic COPD.
Methods
This meta-analysis gathered individual patient data from randomized controlled trials (RCTs) comparing NIPPV plus standard therapy with standard therapy alone. The current analyses are limited to gas exchange parameters.
Results
Our older Cochrane review and 3 new studies were identified, totaling 5 short-term and 2 long-term RCTs. After 3 months (n=162; age 66 yrs; FEV1 0.78L; IPAP 15.4(10-22); EPAP 3.4) we found a significant change in PaCO2 (mean difference= -3.56 (95% CI=-4.93;-2.18 mmHg)) and PaO2 (1.84 (95% CI=0.24; 3.45 mmHg)) but no significant changes after 12 months of NIPPV (n=118).
Conclusions
With the newer studies, this update now finds a significant decrease in PaCO2 and increase in PaO2 in stable hypercapnic COPD patients after 3 months of NIPPV, but not after a year. There was considerable variation in settings; notably inspiratory pressures.
- © 2012 ERS