COPD treatment

• related: COPD, Pulmonology
• tags: #pulmonology

Inhalers

Nocturnal NIPPV

• Casanove, CHEST 2000
  • NIV improves quality of life, reduces CO2 retention, reduces dyspnea
  • no change in mortality or hospitalization
• Murphy 2017:
  • prolongs time to readmission or death for patients with persistent hypercapnia after hospitalization for exacerbation
• Struik 2013: no benefit in gas exchange, quality of life, lung function test in stable COPD
• Kohnlein 2014: Gold 4 pts with CO2 > 52 showed mortality benefit with IPAP 22 and rate 16

Obtaining NIV

• chronic hypercapnia: pCO2 > 52
• nocturnal hypoxemia: spO2 < 88 for > 5 min on 2L or patient's baseline O2
• documentation that sleep apnea has been considered or ruled out