Home ventilation for patients with end-stage chronic obstructive pulmonary disease

Tim Raveling, Heidi Rantala, Marieke Duiverman

Research output: Contribution to journalReview Articlepeer-review

2 Citations (Scopus)
15 Downloads (Pure)

Abstract

Purpose of the review
The number of patients with end-stage chronic obstructive pulmonary disease (COPD) treated with chronic non-invasive ventilation (NIV) has greatly increased. In this review, the authors summarize the evidence for nocturnal NIV and NIV during exercise. The authors discuss the multidisciplinary and advanced care of
patients with end-stage COPD treated with NIV.

Recent findings
Nocturnal NIV improves gas exchange, health-related quality of life and survival in stable hypercapnic COPD patients. Improvements in care delivery have been achieved by relocating care from the hospital to home based; home initiation of chronic NIV is feasible, non-inferior regarding efficacy and cost-effective compared to in-hospital initiation. However, the effect of NIV on symptoms is variable, and applying optimal NIV for end-stage COPD is complex. While exercise-induced dyspnoea is a prominent complaint in end-stage COPD,
nocturnal NIV will not change this. However, NIV applied solely during exercise might improve exercise tolerance and dyspnoea. While chronic NIV is often a long-standing treatment, patient expectations should be discussed early and be managed continuously during the treatment. Further, integration of advance care
planning requires a multidisciplinary approach.

Summary
Although chronic NIV is an effective treatment in end-stage COPD with persistent hypercapnia, there are still important questions that need to be answered to improve care of these severely ill patients.
Original languageEnglish
Pages (from-to)277-282
Number of pages6
JournalCurrent Opinion in Supportive & Palliative Care
Volume17
Issue number4
DOIs
Publication statusPublished - 1 Dec 2023
Publication typeA2 Review article in a scientific journal

Keywords

  • advance care planning
  • COPD
  • non-invasive ventilation
  • quality of life

Publication forum classification

  • Publication forum level 0

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