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Home Mechanical Ventilation in COPD : Do We Know When and How To Use It?

Antonio Antón, MD; Rosa Güell, MD
Author and Funding Information

Barcelona, Spain; Drs. Antón and Güell are from the Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona.

Correspondence to: Antonio Antón, MD, Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, St Antoni Ma Claret 167, 08025 Barcelona, Spain; e-mail: panton@hsp.santpau.es



Chest. 2000;118(6):1525-1526. doi:10.1378/chest.118.6.1525-a
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Extract

In the end stage of COPD, chronic respiratory failure is usually present and most patients are prescribed long-term oxygen therapy.12 However, significant hypercapnia often develops with oxygen administration, particularly at night,3 even when oxygen flow has been adjusted.4 Alternatives to oxygen therapy are scarce, but one promising candidate, noninvasive ventilation (NIV), can theoretically provide benefits by compensating for nighttime hypoventilation,5 allowing respiratory muscles to rest, improving nocturnal gas exchange, and resetting central respiratory control in response to Paco2 concentration. Sleep quality should thereby improve, as should arterial blood gas measures and perhaps daytime symptoms and patient survival.

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