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Respir Med. 2014 May;108(5):722-8. doi: 10.1016/j.rmed.2014.03.006. Epub 2014 Mar 20.

Home non-invasive ventilation use following acute hypercapnic respiratory failure in COPD.

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Temple University, Division of Pulmonary and Critical Care Medicine, Philadelphia, PA, USA. Electronic address:
Temple University, Division of Pulmonary and Critical Care Medicine, Philadelphia, PA, USA.



Patients with COPD and hypercapnic respiratory failure have a worse prognosis and experience a faster deterioration in their pulmonary function. The benefit of home NPPV following an acute exacerbation of COPD with hypercapnic respiratory failure is not well understood.


To evaluate the effect of home NPPV use in patients following a hospitalization for AECOPD with acute hypercapnic respiratory failure on event-free survival after an index admission.


We conducted a retrospective, single-center, chart review on patients hospitalized in 2011 with a diagnosis of AECOPD, hypercapnia, and used NPPV during hospitalization. 166 patients were included and were divided into two groups: patients who used NPPV post discharge and patients who did not.


Patients in the NPPV post discharge group demonstrated superior event-free survival compared to the no-NPPV post discharge group (y2 = 23.8, p < 0.0001). The NPPV post discharge group had a statistically significant reduction in hospital readmissions (40% versus 75%, p < 0.0001) through 180 days from the index admission.


Patients who used NPPV following an admission for AECOPD with hypercapnic respiratory failure had lower readmission rates and improved event-free survival after 180 days from an index admission compared to patients who did not use NPPV post discharge.


BIPAP; COPD; Hypercapnia; Non-invasive positive pressure ventilation; Non-invasive ventilation; Respiratory failure

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