Acute COPD exacerbation treatment with noninvasive ventilation

Sci Rep. 2023 Apr 21;13(1):6586. doi: 10.1038/s41598-023-33871-z.

Abstract

The establishment of a guideline for long-term noninvasive ventilation treatment (LTH-NIV) of acute hypercapnic exacerbations of chronic obstructive pulmonary disease (AECOPD) requiring acute ventilation has proven elusive. Most studies thus far have shown no mortality benefit of long-term noninvasive ventilation treatment. Using retrospective analysis of the data of our patients (n = 143) recruited from 2012 to 2019, we aimed to compare patients discharged with and without long-term noninvasive ventilation. The follow-up results showed no significant difference (p = 0.233) between the groups [LTH-NIV (n = 83); non-NIV (n = 60)] regarding readmission due to clinical worsening. However, the first- and second-year survival rates were 82% and 72%, respectively, in the LTH-NIV group and significantly different (p = 0.023) from 67 and 55% in the non-NIV group. The statistical models showed a significant mortality risk for the non-NIV group, with a hazard ratio (HR) of 2.82 (1.31; 6.03). To the best of our knowledge, this is the first study to demonstrate the mortality benefit of long-term NIV therapy for patients with AECOPD under real-world conditions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Hypercapnia / therapy
  • Lung
  • Noninvasive Ventilation* / methods
  • Pulmonary Disease, Chronic Obstructive* / etiology
  • Respiration, Artificial
  • Respiratory Insufficiency* / etiology
  • Retrospective Studies