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HOME NIV AND REHABILITATION IN COPD
In contrast to the proven benefit of non-invasive ventilation (NIV) for the management of acute hypercapnic respiratory failure, there has been considerable controversy over the last 15 years or so about the use of home NIV in COPD patients with hypercapnic respiratory failure. This has been caused by conflicting results due to studies being of relatively small size, differing patient selection with varying outcomes measured and most performed over a limited time. There has also been some previous evidence that home NIV may be beneficial if added to exercise training. In this months’ Thorax. Duiverman and colleagues report a randomised study of home NIV added to a 3 month course of pulmonary rehabilitation or rehabilitation alone. The results show that the combined treatment produced improvements in several measures of quality of life, functional status and gas exchange though only over a 3 month study period. A considerable number of COPD
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