TY - JOUR
T1 - Home Non Invasive Ventilation (NIV) treatment for COPD patients with a history of NIV-treated exacerbation
T2 - a randomized, controlled, multi-center study
AU - Ankjærgaard, Kasper Linde
AU - Tønnesen, Philip
AU - Laursen, Lars Christian
AU - Hansen, Ejvind Frausing
AU - Andreassen, Helle Frost
AU - Wilcke, Jon Torgny Rostrup
PY - 2016/2/12
Y1 - 2016/2/12
N2 - BACKGROUND: In chronic obstructive pulmonary disease, the prognosis for patients who have survived an episode of acute hypercapnic respiratory failure due to an exacerbation is poor. Despite being shown to improve survival and quality-of-life in stable patients with chronic hypercapnic respiratory failure, long-term noninvasive ventilation is controversial in unstable patients with frequent exacerbations, complicated by acute hypercapnic respiratory failure. In an uncontrolled group of patients with previous episodes of acute hypercapnic respiratory failure, treated with noninvasive ventilation, we have been able to reduce mortality and the number of repeat respiratory failure and readmissions by continuing the acute noninvasive ventilatory therapy as a long-term therapy.METHODS: Multi-center open label randomized controlled trial of 150 patients having survived an admission with noninvasive ventilatory treatment of acute hypercapnic respiratory failure due chronic obstructive pulmonary disease. The included patients are randomized to usual care or to continuing the acute noninvasive ventilation as a long-term therapy, both with a one-year follow-up period. The primary endpoint is time to death or repeat acute hypercapnic respiratory failure; secondary endpoints are one-year mortality, number of readmissions and repeat acute hypercapnic respiratory failure, exacerbations, dyspnea, quality of life, sleep quality, lung function, and arterial gases.DISCUSSION: Though previous studies of long-term noninvasive ventilation have shown conflicting results, we believe the treatment can reduce mortality and readmissions when applied in patients with previous need of acute ventilatory support, regardless of persistent hypercapnia.TRIAL REGISTRATION: clinicaltrials.org: NCT01513655 16-Jan-2012.
AB - BACKGROUND: In chronic obstructive pulmonary disease, the prognosis for patients who have survived an episode of acute hypercapnic respiratory failure due to an exacerbation is poor. Despite being shown to improve survival and quality-of-life in stable patients with chronic hypercapnic respiratory failure, long-term noninvasive ventilation is controversial in unstable patients with frequent exacerbations, complicated by acute hypercapnic respiratory failure. In an uncontrolled group of patients with previous episodes of acute hypercapnic respiratory failure, treated with noninvasive ventilation, we have been able to reduce mortality and the number of repeat respiratory failure and readmissions by continuing the acute noninvasive ventilatory therapy as a long-term therapy.METHODS: Multi-center open label randomized controlled trial of 150 patients having survived an admission with noninvasive ventilatory treatment of acute hypercapnic respiratory failure due chronic obstructive pulmonary disease. The included patients are randomized to usual care or to continuing the acute noninvasive ventilation as a long-term therapy, both with a one-year follow-up period. The primary endpoint is time to death or repeat acute hypercapnic respiratory failure; secondary endpoints are one-year mortality, number of readmissions and repeat acute hypercapnic respiratory failure, exacerbations, dyspnea, quality of life, sleep quality, lung function, and arterial gases.DISCUSSION: Though previous studies of long-term noninvasive ventilation have shown conflicting results, we believe the treatment can reduce mortality and readmissions when applied in patients with previous need of acute ventilatory support, regardless of persistent hypercapnia.TRIAL REGISTRATION: clinicaltrials.org: NCT01513655 16-Jan-2012.
KW - Cohort Studies
KW - Home Care Services
KW - Hospitalization
KW - Humans
KW - Hypercapnia
KW - Noninvasive Ventilation
KW - Patient Readmission
KW - Pulmonary Disease, Chronic Obstructive
KW - Respiratory Insufficiency
KW - Retrospective Studies
KW - Survival Rate
KW - Journal Article
KW - Multicenter Study
KW - Randomized Controlled Trial
U2 - 10.1186/s12890-016-0184-6
DO - 10.1186/s12890-016-0184-6
M3 - Journal article
C2 - 26867542
SN - 1471-2466
VL - 16
SP - 1
EP - 5
JO - BMC Pulmonary Medicine
JF - BMC Pulmonary Medicine
M1 - 32
ER -