Which patients are most suitable for noninvasive ventilation (NIV) in chronic obstructive pulmonary disease (COPD)?

Updated: Jun 18, 2020
  • Author: Guy W Soo Hoo, MD, MPH; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Answer

COPD is the most suitable condition for noninvasive ventilation.

Noninvasive ventilation is most effective in patients with moderate-to-severe disease

Hypercapnic respiratory acidosis may define the best responders (pH 7.20-7.30). Noninvasive ventilation is also effective in patients with a pH of 7.35-7.30, but no added benefit is appreciated if the pH is greater than 7.35. The lowest threshold of effectiveness is unknown, but success has been achieved with pH values as low as 7.10.

Obtunded COPD patients can be treated, but the success rate is lower.

Improvement after a 1- to 2-hour trial may predict success.

Also see the clinical guidelines summary, Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. [23]


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