Long-Term Noninvasive Ventilation in
Chronic Stable Hypercapnic COPD: Guideline Update
September 20, 2023
12 PM ET; 11 AM CT; 9 AM PT
Rich Branson MSc, RRT, FAARC
Professor, University of Cincinnati College of Medicine
Editor-in-Chief, Respiratory Care
In 2021, a multi-organizational effort was undertaken to review the optimum delivery of NIV for stable, hypercapnic COPD in the home. This expert panel closely followed the publication of the American Thoracic Society (ATS) and European Respiratory Society (ERS) guidelines on long-term NIV use. Both groups found that removal of overnight oximetry testing, initiation of therapy using BiPap devices with a back-up rate and increased duration of time to meet adherence criteria were important for improved NIV success across the continuum of care. From a clinical standpoint, it was suggested that the use of nocturnal NIV should be included in standard medical care for hypercapnic COPD and that patients be screened for obstructive sleep apnea (OSA) prior to NIV initiation. These new recommendations provide some clarity regarding the use of chronic NIV but also provide a road map for future studies.
After this activity, the participant will be able to:
Describe the process for developing guidelines for long-term NIV including the development of PICO questions and grading of the literature
Describe the timing and goals of NIV in chronic hypercapnic COPD and how these relate to NIV success
Discuss understand patient selection, impact of comorbidities on diagnostics and outcomes of NIV use and the importance of reducing hypercapnia on treatment success
Rich Branson has been a respiratory therapist for 40 years. He is currently Professor in the College of Medicine at the University of Cincinnati in the Division of Trauma & Critical Care and Editor in Chief of Respiratory Care. He has written extensively on metabolic measurements and methods of measuring energy expenditure. Mr. Branson is a fellow of the American Association for Respiratory Care and of the American College of Critical Care Medicine. He has published over 300 manuscripts in the peer- reviewed literature, over 100 book chapters and edited two texts.