RT Journal Article
SR Electronic
T1 Meta-analysis on nocturnal non-invasive positive pressure ventilation for stable COPD; an update
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P1713
VO 40
IS Suppl 56
A1 Fransien Struik
A1 Yves Lacasse
A1 Huib Kerstjens
A1 Peter Wijkstra
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P1713.abstract
AB IntroductionNocturnal 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.MethodsThis 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.ResultsOur 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).ConclusionsWith 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.