Home noninvasive ventilatory support for patients with chronic obstructive pulmonary disease: patient selection and perspectives

Abstract

Jan Hendrik Storre,1,2 Jens Callegari,3 Friederike Sophie Magnet,3 Sarah Bettina Schwarz,3 Marieke Leontine Duiverman,4,5 Peter Jan Wijkstra,4,5 Wolfram Windisch3 1Department of Intensive Care, Sleep Medicine and Mechanical Ventilation, Asklepios Fachkliniken Munich-Gauting, Gauting, Germany; 2Department of Pneumology, University Medical Hospital, Freiburg, Germany; 3Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Köln gGmbH Witten/Herdecke University, Faculty of Health/School of Medicine, Cologne, Germany; 4Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; 5Groningen Research Institute of Asthma and COPD (GRIAC), University of Groningen, Groningen, the Netherlands Abstract: Long-term or home mechanical noninvasive ventilation (Home-NIV) has become a well-established form of therapy over the last few decades for chronic hypercapnic COPD patients in European countries. However, meta-analyses and clinical guidelines do not recommend Home-NIV for COPD patients on a routine basis. In particular, there is ongoing debate about Home-NIV in chronic hypercapnic COPD regarding the overall effects, the most favorable treatment strategy, the selection of eligible patients, and the time point at which it is prescribed. The current review focuses on specific aspects of patient selection and discusses the various scientific as well as clinical-guided perspectives on Home-NIV in patients suffering from chronic hypercapnic COPD. In addition, special attention will be given to the topic of ventilator settings and interfaces. Keywords: exacerbation, pulmonary emphysema, hypercapnia, mechanical ventilation, respiratory insufficiency

Keywords

• exacerbation
• pulmonary emphysema
• hypercapnia
• mechanical ventilation
• respiratory insufficiency