Home Non-Invasive Ventilation for COPD:
How, Who and When?
Non-invasive ventilation (NIV) to treat exacerbations of COPD is considered standard clinical practice. However, until recently, the evidence for home oxygen therapy (HOT) with additional home mechanical ventilation (HMV) to treat post-acute COPD patients with persistent hypercapnic respiratory failure had been lacking. The HOT-HMV trial addressed this clinical question with the application of high levels of pressure support & home oxygen combined with targeted management of chronic respiratory failure, and demonstrated a substantial improvement in admission-free survival. With a focus on patients with persistent hypercapnic respiratory failure following a life-threatening exacerbation, HOT-HMV treatment was shown to be both clinically and cost-effective in the home environment.
Discuss who should we target for HOT-HMV treatment
Discuss when should be start HOT-HMV treatment
Discuss how should we deliver HOT-HMV treatment
Professor Nicholas Hart is the Director of the Lane Fox Respiratory Service at Guy's and St Thomas’ NHS Foundation Trust. His other current roles include: Professor of Respiratory and Critical Care Medicine, Faculty of Life Sciences and Medicine, School of Basic and Medical BioSciences, King's College London. Prof. Hart was appointed in April 2012 as the director of the Lane Fox Respiratory service, which is an internationally recognized weaning, rehabilitation and home mechanical ventilation service.
Prof Hart’s research interests focuses on enhancing the long-term outcome of patients with chronic respiratory disease and post critical illness. This includes readmission prevention in acute COPD, prevention of skeletal muscle wasting during acute illness and clinical trials to improve long-term outcome in sleep disordered breathing and chronic respiratory failure.
Prof. Hart has published extensively in many peer-reviewed journals including the Journal of the American Medical Association, American Journal of Respiratory and Critical Care Medicine, Critical Care Medicine, European Respiratory Journal, Thorax, Chest, to name a few. Nicholas has been awarded nine Local Clinical Excellence Award points.