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

Another study [59] was unable to show an improvement in 2-year survival, despite the demonstration of reductions in day-time PaCO 2 (while breathing oxygen), improvements in health status, and reductions in readmissions. Therefore, it appears unlikely that differences in 1 year survival between the Köhnlein study [52] and others [58, 59] are due only to "high inspiratory pressures" or simply reductions in PaCO 2 [52] . As a matter of fact, the control group of the Köhnlein study suffered from a high mortality rate, which may indicate that severity of disease rather than the correction of hypercapnia or the beneficial effect of "high inspiratory pressures" primarily drives survival in patients treated with NPPV. Furthermore, claim that chronic hypercapnia is associated to worse survival is questionable -at least in those patients receiving long-term oxygen therapy [43] . Furthermore there is growing evidence that mortality in COPD is influenced by several other factors, such as exercise capacity, comorbidities and inflammatory status [60] .