Noninvasive ventilation in pulmonary rehabilitation of COPD patients

SummaryNoninvasive positive pressure ventilation (NIPPV) has been shown to improve exercise tolerance and health-related quality of life in patients with advanced COPD. This study tested the feasibility of nocturnal NIPPV as an additional tool in a hospital-based pulmonary rehabilitation program. This prospective observational trial included forty COPD patients in GOLD stage IV. NIPPV was successfully introduced and accepted during sleep by all patients. All patients received pressure support ventilation for 7.9±0.5h per day with an inspiratory support of 17.5±4.4cmH2O, and an expiratory pressure of 4.5±0.9cmH2O. The outcome of pulmonary rehabilitation in patients receiving nocturnal NIPPV was compared with the results of forty matched control patients who underwent the same program. Rehabilitation with nocturnal NIPPV resulted in the 6-minute walk test and in the longest non-stop walk distance in improvements of 82 and 89m, respectively, while patients without nocturnal ventilatory support improved by 50 and 51m (p<0.04 and p