TABLE 1

Recommendations for PICO (target population-intervention-comparator-outcome) questions

QuestionRecommendation
Should LTH-NIV be used in stable patients with COPD (as compared to not using NIV)?The ERS task force suggests LTH-NIV be used for patients with chronic stable hypercapnic COPD (conditional recommendation, low certainty evidence).
Should LTH-NIV be used after an episode of acute hypercapnic respiratory failure in patients with COPD (as compared to not using NIV)?The ERS task force suggests LTH-NIV be used in patients with COPD following a life-threatening episode of acute hypercapnic respiratory failure requiring acute NIV, if hypercapnia persists following the episode (conditional recommendation, low certainty evidence).
When using LTH-NIV in COPD patients, should NIV settings be titrated to normalise or at least cause a significant reduction in PaCO2 (as compared to titrating not according to PaCO2 levels)?The ERS task force suggests titrating LTH-NIV to normalise or reduce PaCO2 levels in patients with COPD (conditional recommendation, very low certainty evidence).
When using LTH-NIV in COPD patients, should we use fixed pressure modes (as compared to adaptive or auto-titrating pressure modes)?The ERS task force suggests using fixed pressure support mode as first-choice ventilator mode in patients with COPD using LTH-NIV (conditional recommendation, very low certainty evidence).

LTH-NIV: long-term home non-invasive ventilation; NIV: non-invasive ventilation; PaCO2: partial pressure of carbon dioxide in arterial blood.