Journal article
Initiation of home noninvasive ventilation in hypercapnic chronic obstructive pulmonary disease: when, where, and how?
Current opinion in pulmonary medicine, Vol.31(2), pp.165-174
03/2025
DOI: 10.1097/MCP.0000000000001139
PMID: 39699122
Abstract
Purpose of review This review aims to highlight the importance of timely initiation of home noninvasive ventilation (homeNIV) for patients with chronic hypercapnic respiratory failure (CHRF) due to chronic obstructive pulmonary disease (COPD). As emerging evidence continues to show substantial benefits in reducing mortality and hospitalizations, it's crucial to identify which patients will benefit most and to provide clear guidance on implementing homeNIV effectively. Recent findings Recent research supports the use of high intensity homeNIV for CHRF secondary to COPD, showing marked reductions in hospitalizations and mortality. However, despite its proven benefits, homeNIV is underutilized, often due to significant barriers related to payor policies and gaps in knowledge by those most likely to be evaluating and managing patients with advanced COPD. The literature also reveals ongoing debate about the optimal timing and setting for starting homeNIV, whether in outpatient clinics or directly after hospital discharge. Summary The evidence suggests that homeNIV should be more widely used, with a focus on early initiation and careful titration to normalize PaCO 2 over time. By addressing the barriers to its broader use, we can improve outcomes for patients with CHRF due to COPD.
Details
- Title: Subtitle
- Initiation of home noninvasive ventilation in hypercapnic chronic obstructive pulmonary disease: when, where, and how?
- Creators
- Spyridon Fortis - Iowa City VA Health Care SystemKathleen F. Sarmiento - San Francisco VA Health Care System
- Resource Type
- Journal article
- Publication Details
- Current opinion in pulmonary medicine, Vol.31(2), pp.165-174
- DOI
- 10.1097/MCP.0000000000001139
- PMID
- 39699122
- NLM abbreviation
- Curr Opin Pulm Med
- ISSN
- 1070-5287
- eISSN
- 1531-6971
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Grant note
- Office of Rural Health
Dr Fortis has received grant from Office of Rural Health, served a consultant for Society of Hospital Medicine (SHM), and has stock options with ROMTech. Dr Sarmiento has no conflicts of interest germane to this manuscript.
- Language
- English
- Electronic publication date
- 11/15/2024
- Date published
- 03/2025
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984749758602771
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