Facts about COPD?
Chronic obstructive pulmonary disease (COPD) is currently third on the World Health Organization’s list of the leading causes of death. In 2019, COPD led to 3.23 million* deaths globally.
Providing non-invasive ventilation (NIV) at home is now widely accepted as a successful solution for patients with advanced, severe COPD and chronic hypercapnia respiratory failure.
Outcomes from recent studies
NIV for severe stable COPD
According to the results of a randomized, controlled trial published in The Lancet, effective NIV treatment significantly improved the survival rate of patients with stable hypercapnic COPD – mortality risk was reduced by 76 percent over a one-year period. It also revealed that patients using NIV experienced considerably higher quality of life, as measured by the St. George’s Respiratory Questionnaire.
Home Oxygen and NIV for COPD
This study included 116 severe hypoxic and hypercapnic COPD patients, who were admitted to hospital for acute decompensated hypercapnic exacerbation of COPD. After receiving acute NIV treatment and discharge from the hospital, the patients were still hypoxic (PaO2<55mmHg) and hypercapnic (PaCO2>53mmHg) two to four weeks after resolution of the acute exacerbation. Among patients treated at home, those that received both oxygen therapy and noninvasive
ventilation (HOT – HMV) showed a 51 percent reduction in the risk of hospital readmission or death, compared with patients that only received oxygen therapy (HOT).
In the first 28 days, following randomization, there was a 74 percent reduction in the probability of hospital readmission, amongst patients receiving combined HOT and HMV, with two-thirds fewer incidents tolerated by the patients.
Further analysis revealed that the exacerbation rate was decreased by 34 percent among patients receiving combined HOT-HMV treatment. In addition, combined treatment had a positive effect on time to first readmission and reduced mortality risk.
The treatment
Treating hypercapnic COPD patients is complex, as each patient has different needs. In many cases, the disease state may vary and develop over time. Ventilators that vary expiratory positive airway have auto-titrating functions, such as Auto-EPAP and Target Volume, have frequently proved an effective solution. As COPD patients often have difficulty clearing mucus, they may also benefit from the use of an integrated humidifier and heated circuit.
Vivo 1-2-3
- Noninvasive ventilation
- Auto-EPAP
- Integrated humidifier
- Heated wire circuit
- Quiet and compact
- Connects to EveryWare
- Remote setting changes
- Target Volume**
- O2 bleed-in 30l
- High Flow Nasal Therapy*
- Internal Battery*
- Full range of alarms
*Only on Vivo 3
** Only Vivo 2 and 3
*** Only on Vivo 45
Vivo 45/Nippy 4
- Noninvasive ventilation
- Auto-EPAP
- Target Volume
- Integrated humidifier
- Heated wire circuit
- Connects to EveryWare
- O2 bleed-in
- CO2 measurement
- SpO2 measurement
- Effort Belts***
- Full range of alarms
Aging population and increasing prevalence of diseases such as COPD will add a significant pressure on healthcare systems globally and it is of importance to set up and follow up on these patients as effectively as possible. Using systems like Breas EveryWare remote solution will help you manage your patient with ease and confidence. It will save costs for the healthcare system, patient days in the hospital, and follow up meetings as this can be managed when the patient can be in a home environment.
Summary of the ERS Guidelines
A multidisciplinary ERS Task Force committee has published a guideline providing evidence-based recommendations for the use of NIV at home. In summary, the ERS guideline supports the use of long-term NIV in targeting a reduction in CO2 in COPD patients with persistent hypercapnic respiratory failure. Click or scan the QR code to go to educationbybreas.com, where you can find all our educational material for free.
