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. 2023 Apr 21;13(1):6586.
doi: 10.1038/s41598-023-33871-z.

Acute COPD exacerbation treatment with noninvasive ventilation

Ewert Ralf  1 , Alexander Heine  1 , Anne Obst  1 , Karoline Koerner  1 , Veit Hustig-Kittler  1 , Michael Boesche  1 , Mohamed Elhadad  1 , Beate Stubbe  2 , Michael Westhoff  3   4
Affiliations

Acute COPD exacerbation treatment with noninvasive ventilation

Ewert Ralf et al. Sci Rep. .

Abstract

The establishment of a guideline for long-term noninvasive ventilation treatment (LTH-NIV) of acute hypercapnic exacerbations of chronic obstructive pulmonary disease (AECOPD) requiring acute ventilation has proven elusive. Most studies thus far have shown no mortality benefit of long-term noninvasive ventilation treatment. Using retrospective analysis of the data of our patients (n = 143) recruited from 2012 to 2019, we aimed to compare patients discharged with and without long-term noninvasive ventilation. The follow-up results showed no significant difference (p = 0.233) between the groups [LTH-NIV (n = 83); non-NIV (n = 60)] regarding readmission due to clinical worsening. However, the first- and second-year survival rates were 82% and 72%, respectively, in the LTH-NIV group and significantly different (p = 0.023) from 67 and 55% in the non-NIV group. The statistical models showed a significant mortality risk for the non-NIV group, with a hazard ratio (HR) of 2.82 (1.31; 6.03). To the best of our knowledge, this is the first study to demonstrate the mortality benefit of long-term NIV therapy for patients with AECOPD under real-world conditions.

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Conflict of interest statement

RE: Honoraria for scientific lectures from Actelion, GSK, United Therapeutics, AstraZeneca, Novartis, Berlin Chemie, Boehringer Ingelheim, and OMT, and research funding from Boehringer Ingelheim and Actelion Germany. MW: Honoria for scientific lectures from Löwenstein, Boehringer Ingelheim and Janssen. AH, AO, KK, VHK, MB, ME, BS: No potential conflict of interest to report.

Figures

Figure 1
Figure 1
Flow chart of the study design.
Figure 2
Figure 2
Comparison of selected BGA-values between LTH-NIV patients (a) and Non-NIV patients (b).
Figure 3
Figure 3
Comparison of pH (a), paCO2 (b) and HCO3− (c) between LTH-NIV patients and Non-NIV patients depending on the time of discharge or last follow-up.
Figure 4
Figure 4
Comparison of survival curves between LTH-NIV patients and Non-NIV patients.
See this image and copyright information in PMC

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