8(th) International conference on management and rehabilitation of chronic respiratory failure: the long summaries – Part 3

Ambrosino, Nicolino; Casaburi, Richard; Chetta, Alfredo; Clini, Enrico; Donner, Claudio F.; Dreher, Michael; Goldstein, Roger; Jubran, Amal; Nici, Linda; Owen, Caroline A.; Rochester, Carolyn; Tobin, Martin J.; Vagheggini, Guido; Vitacca, Michele; ZuWallack, Richard

The use of NPPV is a first line treatment of acute on chronic hypercapnic respiratory failure in COPD patients [8] . However, once acute hypercapnic respiratory failure is successfully managed and these patients are discharged, there is an 80 % re-hospitalization rate due to another acute exacerbation over the following year [53] . Furthermore, long-term survival in this patient cohort remains poor [54] . Three relatively small studies investigated the effect of home NPPV after acute hypercapnic respiratory failure successfully treated in COPD patients. One study showed that, compared to sham (continuous positive airway pressure) ventilation, NPPV significantly reduced the probability of recurrent acute hypercapnic respiratory failure [55] . Another study compared home NPPV versus standard therapy in chronic hypercapnic respiratory failure patients after acute exacerbation in order to prevent clinical worsening [56] . The authors demonstrated that the probability of clinical worsening was significantly lower in the group receiving home NPPV, with additional improvements observed in exercise capacity. The third, retrospective, study demonstrated better survival in COPD patients discharged after acute respiratory failure with home NPPV compared to those discharged without this form of therapy [57] .