6/28/23, 11:22 PM NIV in COPD with chronic hypercapnia Pathway Feedback Search Clinical Topics Home Studies NIV in COPD with chronic hypercapnia NIV in COPD with chronic hypercapnia Disease Disease Chronic obstructive pulmonary Dyspnea in palliative care Trial question What is the effect of home noninvasive ventilation plus oxygen therapy in patients with persistent hypercapnia after an acute COPD exacerbation? Study design Multi-center Open label RCT Population Characteristics of study participants 53.0% female N = 116 47.0% male 116 patients (61 female, 55 male) Inclusion criteria: patients with persistent hypercapnia (arterial partial pressure of CO2 > 53 mmHg) who had an acute COPD exacerbation Key exclusion criteria: obesity (BMI > 35), obstructive sleep apnea syndrome, or other causes of respiratory failure Interventions N=57 home noninvasive ventilation plus oxygen therapy (ventilator setting are inspiratory positive airway pressure of 24 cmH O, an EPAP of 4 cmH O, and a backup rate of 14 breaths/minute plus median oxygen flow rate of 1.0 L/min) N=59 home oxygen therapy alone (median oxygen flow rate, 1.0 L/min) https://web.pathway.md/studies/recLh4IxpvcVeFQoN 1/2 6/28/23, 11:22 PM NIV in COPD with chronic hypercapnia Pathway Primary outcome Readmission or death at 12 months 80.4 % 80.4 63.4 60.3 % 40.2 % 20.1 % No significant difference 0.0 % Home noninvasive ventilation plus oxygen therapy Home oxygen therapy alone No significant difference in readmission or death at 12 months (63.4% vs. 80.4%; ARR 17, 95% CI 0.1 to 34) Conclusion In patients with persistent hypercapnia (arterial partial pressure of CO2 > 53 mmHg) who had an acute COPD exacerbation, home noninvasive ventilation plus oxygen therapy was superior to home oxygen therapy alone with respect to readmission or death at 12 months. Reference Murphy PB, Rehal S, Arbane G et al. Effect of Home Noninvasive Ventilation With Oxygen Therapy vs Oxygen Therapy Alone on Hospital Readmission or Death After an Acute COPD Exacerbation: A Randomized Clinical Trial. JAMA. 2017 Jun 6;317(21):2177-2186. Open reference URL https://web.pathway.md/studies/recLh4IxpvcVeFQoN 2/2