The Use of Home Noninvasive Ventilation in Chronic Hypercapnic Chronic Obstructive Pulmonary Disease
Michael R. Jacobs 1, Gerard J. Criner 1
1 Temple Lung Center, Temple University School of Medicine, Philadelphia, USA
*Correspondence: Gerard J. Criner, Email not available
Abstract
The primary objective of this review is to assess the role of noninvasive ventilation in the management of chronic obstructive pulmonary disease (COPD) patients with clinically stable hypercapnic respiratory failure. Noninvasive ventilation can be provided by either negative-pressure or positive-pressure devices. Of the two methods, positive-pressure devices are more commonly employed and are the focus of this review. The use of noninvasive positive-pressure ventilation is widely accepted for the management of hypercapnic respiratory failure in hospitalized COPD patients during exacerbations. However, the value of chronic home noninvasive positive-pressure ventilation for hypercapnic respiratory failure in stable patients with COPD is unresolved. Questions remain regarding the selection of patients most likely to benefit from home noninvasive positive-pressure ventilation for stable COPD, the inspiratory pressures that should be administered, and how to maximize patient compliance. We review the available evidence to help elucidate what is known and what remains to be determined regarding the use of chronic home noninvasive positive-pressure ventilation in these patients.
