title: Long-term non-invasive ventilation reduces readmissions in COPD patients with two or more episodes of acute hypercapnic respiratory failure.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) patients who have had an episode of acute hypercapnic respiratory failure (AHRF) have a large 1-year risk of death or readmission. Acute non-invasive ventilation (NIV) has been shown to be an effective treatment of AHRF; and long-term NIV (LTNIV) has been shown to be an effective treatment of chronic respiratory failure in stable hypercapnic COPD. We investigated the effects of LTNIV in a group of patients with severe, unstable COPD: frequent admissions and multiple previous episodes of AHRF treated with NIV.
  
  
  METHODS
  We conducted a retrospective analysis of 20 COPD patients treated with LTNIV after two or more episodes of AHRF during 1 year.
  
  
  RESULTS
  The mean number of AHRF episodes decreased from 2.44 in the year prior to LTNIV initiation to 0.44 in the year following (p<0.0001). The median number of admissions decreased from 5.19 to 1.88 (p=0.0092). Four patients (20%) died in 1 year. LTNIV tended to reduce arterial CO2. No changes were found in lung function.
  
  
  CONCLUSIONS
  LTNIV seems effective in reducing recurrent AHRF and readmissions in a highly select group of patients with severe, unstable COPD and frequent AHRF.
authors.affiliation: Department of Pulmonary Medicine, Gentofte Hospital, Hellerup, Denmark; ankjaergaard@live.dk.
authors.forename: Kasper Linde
authors.initials: KL
authors.lastname: Ankjærgaard
authors.affiliation: Department of Pulmonary Medicine, Gentofte Hospital, Hellerup, Denmark.
authors.forename: Sophia Liff
authors.initials: SL
authors.lastname: Maibom
authors.affiliation: Department of Pulmonary Medicine, Gentofte Hospital, Hellerup, Denmark.
authors.forename: Jon Torgny
authors.initials: JT
authors.lastname: Wilcke
keywords: COPD; exacerbations; hypercapnia; respiratory failure; ventilation