2019 ERS guidelines on long-term home NIV for management of COPD available

30 August, 2019

A multidisciplinary ERS Task Force committee comprised of clinicians, methodologists and experts in the field of non-invasive ventilation (NIV) have published updated guidelines focused on the use of long-term home NIV for the management of chronic obstructive pulmonary disease (COPD).

The guidelines, published in the European Respiratory Journal, provide evidence-based recommendations for the clinical application of long-term home NIV in chronic hypercapnic COPD patients. The recommendations are accompanied by discussions of implementation considerations and suggestions for future research.

The Task Force committee offers conditional recommendations for four actionable PICO (target population, intervention, comparator and outcome) questions:

  • Use of long-term home NIV in stable hypercapnic COPD;
  • Use of long-term home NIV in COPD patients following a COPD exacerbation requiring acute NIV;
  • Use of NIV settings targeting a reduction in carbon dioxide;
  • And using fixed pressure support as first choice ventilator mode.

The guidelines also discuss key factors that may impact the effectiveness of long-term home NIV in COPD management, including patient age, treatment adherence and presence of comorbidities, equipment related factors, and therapies that may be used in addition to NIV.

The committee advises that these recommendations should be applied in clinical practice by practitioners who routinely care for chronic hypercapnic COPD patients, and say that progress in the field of long-term home NIV means the recommendations will require re-evaluation in the future.