Home noninvasive ventilation use in patients hospitalized with COPD

Abstract

Introduction

The study objective was to estimate the prevalence of chronic hypercapnic respiratory failure (CHRF) and home noninvasive ventilation (NIV) use in a high‐risk population, individuals with a history of at least one COPD‐related hospitalizations.

Methods

We retrospectively analyzed electronic medical record data of patients with at least one COPD‐related hospitalization between October 1, 2011, and September 30, 2017, to the Iowa City VA Medical Center. We excluded individuals with no obstructive ventilatory defect.

Results

Of 186 patients, the overall prevalence of compensated hypercapnic respiratory failure (CompHRF), defined as PaCO ₂ > 45 mmHg with a pH = 7.35–7.45, was 52.7%, while the overall prevalence of home NIV was 4.3%. The prevalence of CompHRF was 43.6% and home NIV was 1.8% in those with one COPD‐related hospitalization. Among those with ≥4 COPD‐related hospitalizations, the prevalence of CompHRF was 77.8% (14 of 18), and home NIV was 11.1% (2 of 18).

Conclusion

Approximately half of individuals with at least one COPD‐related hospitalization have CompHRF, but only 8.2% of those use home NIV. Future studies should estimate CHRF rates and the degree of underutilization of home NIV in larger multicenter samples.

Abstract

Approximately half of individuals with at least one COPD‐related hospitalization have hypercapnia, but only 8.2% of those use home noninvasive ventilation. Future studies should estimate chronic hypercapnic respiratory failure rates and the degree of underutilization of home noninvasive ventilation in larger multicenter samples and identify barriers and facilitators for home noninvasive ventilation use in patients with COPD‐related hospitalizations.