EDITORIALS
Domiciliary non-invasive ventilation in stable COPD?
Correspondence to:
Dr M W Elliott, Department of Respiratory Medicine, St James’s University Hospital, Beckett Street, Leeds LS9 7TF, UK; mwelliott@doctors.org.uk
| The first 150 words of the full text of this article appear below. |
Chronic obstructive pulmonary disease (COPD) is the commonest indication for domiciliary non-invasive ventilation (NIV) in Europe.1 However, there is a paucity of evidence to support its use. A number of short-term randomised controlled trials (RCTs) failed to show any consistent benefit from NIV.2–5 In a crossover study comparing 3 months of bilevel ventilation plus long term oxygen therapy (LTOT) with LTOT alone,6 there were small improvements in arterial blood gas tensions during spontaneous breathing by day and in health-related quality of life (QOL) with NIV. In a longer term RCT,7 20 patients randomised to NIV were compared with 24 controls; there was a reduction in the need for hospitalisation in the first 3 months in the NIV group but this effect disappeared by 1 year. One-year survival (78%) was similar in both groups. Dyspnoea, measured using the Borg scale, was reduced in the NIV group. In a larger RCT from
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