Abstract
Background: Although home NIV use in stable hypercapinc COPD patients is suggested, the benefits of this intervention are still controversial.
Aims and Objectives: To investigate the effect of long-term NIV use on the rate and severity of acute exacerbations, clinical symptoms and mortality in patients with hypercapnic COPD.
Methods: NIV in the spontaneous/timed mode was administered in stable hypercapnic COPD patients 3-4 weeks after admission for acute-on-chronic hypercapnic respiratory failure. Exclusion criteria were: a) BMI>35 kg/m2, b) diagnosed or clinical suspicion of OSA, c) unable to tolerate NIV or poor compliance. Number of exacerbations, arterial blood gases and COPD Assessment Test (CAT) were assessed before and 2 years after NIV initiation. Severe exacerbation was defined as hospitalization and moderate was defined as treatment with systemic corticosteroids and/or antibiotics.
Results: 64 patients (75% men, mean age 70) were included. From baseline to 24 months, there was a significant improvement in moderate (1 vs 1.9, p=0.007) and severe exacerbations (0.5 vs 1.6, p=0.001), CAT score (p<0.001), PO2 (p<0.001) and PCO2 (p<0.001). Patients who responded positively to NIV were >70 years, had higher PO2 at baseline (60 vs 52 mmHg) and lower prevalence of comorbidities compared to non responders. 29% of patients died, 6-32 months after NIV initiation. Patients with lower FEV1 and increased PCO2 at baseline were found to have a greater risk of death (p<0.001).
Conclusions: Early NIV in stable COPD patients, when needed, seems to have beneficial effect on rate and severity of exacerbations, arterial blood gases and clinical symptoms.
Footnotes
Cite this article as Eur Respir J 2022; 60: Suppl. 66, 2913.
This article was presented at the 2022 ERS International Congress, in session “-”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
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