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  • Domiciliary long-term non-invasive ventilation in COPD: should we select subgroups with a better likelihood to respond to NIV in subsequent randomised controlled trials?

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Correspondence
Domiciliary long-term non-invasive ventilation in COPD: should we select subgroups with a better likelihood to respond to NIV in subsequent randomised controlled trials?
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  1. Jean-Christian Borel1,2,
  2. Christophe Pison3,4,5,
  3. Jean-François Timsit6,7,
  4. Jean-Louis Pepin1,8
  1. 1Univ Grenoble Alpes, HP2 INSERM U1042, Grenoble, France
  2. 2AGIR à dom, Non Profit Home Care Provider, Meylan, France
  3. 3Clinique Universitaire de Pneumologie, Pôle Thorax et Vaisseaux, Grenoble University Hospital, Grenoble, France
  4. 4European Institute for Systems Biology and Medicine, EISBM, Lyon, France
  5. 5INSERM 1055, Univ Grenoble Alpes, Grenoble, France
  6. 6Service de Réanimation Médicale, Pôle Urgences Médecine Aigüe, Grenoble University Hospital, Grenoble, France
  7. 7Service de Réanimation Médicale, Hôpital Bichat-APHP, Paris, France
  8. 8Clinique Universitaire de Physiologie et Sommeil, Pôle Thorax et Vaisseaux, Grenoble University Hospital, Grenoble, France
  1. Correspondence to Dr Jean-Christian Borel, AGIR à dom Association, 19, bd de la Chantourne, 38700 La Tronche-France; j.borel{at}agiradom.com

https://doi.org/10.1136/thoraxjnl-2014-205949

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    The efficacy of non-invasive ventilation (NIV) for severe COPD exacerbation has been unambiguously demonstrated. The study by Struik et al recently published in Thorax1 demonstrates that pursuing nocturnal NIV after acute respiratory failure in patients with COPD exhibiting prolonged hypercapnia >48 h after termination of ventilatory support does not reduce time to readmission or rate of deaths at 1 year. They included a mixed cohort of patients with acute-on-chronic and acute respiratory failures. However, in future studies it may be interesting to select patients with persistent hypercapnia several weeks after the acute exacerbation episode. Nevertheless, long-term …

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