Which of Your COPD Patients Can Benefit From Non-Invasive Ventilation?

Non-invasive ventilation (NIV) is a widely used, effective therapy for the delivery of assisted ventilatory support without the use of an endotracheal tube or tracheostomy tube (commonly referred to as invasive ventilation).

Over the past 20 years, NIV has become an integral tool to manage acute and chronic respiratory failure—both in the critical care unit and at home.

Advantages of NIV For Patients With COPD

The primary goal of NIV is to reduce breathing problems for people in chronic respiratory failure. To achieve this goal, NIV offers a variety of advantages:

• Decreases the work of breathing and burden on respiratory muscles
• Reduces daytime sleepiness and morning headaches
• Improves sleep quality
• Maintains or improves the oxygen/carbon dioxide levels in the blood
• Inflates the lungs more fully
• Reduces the risk of hospitalization
• Improves quality of life

COPD is a progressive disease and it is important to monitor the disease advancement in a patient. As COPD progresses to later stages, NIV may be appropriate for patients and offer improved outcomes.

Refer Your Patient to Apria: Contact Us About NIV

Patient selection is key to the successful use of NIV. This article provides guidance to help you identify your patients who may be appropriate candidates for NIV.

Appropriate Candidates for NIV

NIV therapy is appropriate for patients with chronic respiratory failure due to COPD, which includes chronic bronchitis and emphysema.

Studies show that NIV decreases the need for intubation, decreases mortality, and reduces complications in these patients.¹

When started early, NIV can help keep COPD from getting worse while reducing hospital admission rates, length of stay, and healthcare costs, and while maintaining or improving quality of life.²

Qualifying Questions to Ask

The following are questions to ask when identifying patients who may benefit from
non-invasive ventilation therapy:

• Does the patient have COPD?
• Does the patient have chronic respiratory failure?
• Is the patient’s chronic respiratory failure caused by COPD?
• During the last 12 months, has the patient been admitted to the hospital for COPD exacerbations?
• Does the patient have at least one of the testing requirements listed below?

Testing Requirements

The appropriate candidate for NIV should have one of the following testing requirements:

Arterial blood gas:

• pCO2 ≥ 52 mmHg

Pulmonary function test:

• FEV1 ≤ 50% of predicted

Metabolic bi-carb:

• CO2 / HCO3- > 31 mmol/L

End-tidal carbon dioxide:

• etCO2 ≥ 48 mmHg for 5 minutes or more during a test lasting at least 2 hours

Test plus hospital admissions:

• pCO2 between 48 – 51 mmHg or FEV1 ≤ 51 – 60% of predicted and 2 or more respiratory-related hospital admissions within the past 12 months
  

Apria is a Leader in NIV Treatment and COPD Management

Non-invasive positive ventilation is an important tool to help you more effectively treat your patients with chronic respiratory failure due to COPD. At Apria, we offer a wide range of treatment options and will work closely with you to customize a treatment plan that best suits the needs of your patients.

Refer Your Patient to Apria: Contact Us About NIV

Get More Information: Care For COPD & Breathing Problems

1. Keenan SP, et al. Effect of noninvasive positive pressure ventilation on mortality in patients admitted with acute respiratory failure: a meta-analysis.
   Crit Care Med. 1997;25:1685-1692.
2. Lightowler JV, et al. Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of COPD: Cochrane systematic review and meta-analysis. BMJ. 2003:326(7382):185.