Nav: Home

New hope for COPD patients possible with in-home device

February 04, 2020

ROCHESTER, Minn. -- In a new paper published Feb. 4 in JAMA, Mayo Clinic researchers describe the benefits of in-home noninvasive ventilation therapy ? which includes a type referred to as bilevel positive airway pressure, or BiPAP ? for many patients with chronic obstructive pulmonary disease (COPD). The team identified a number of benefits, including reduced mortality, fewer hospital admissions, lower risk of intubation, improved shortness of breath, and fewer emergency department visits.

COPD is a chronic lung disease that makes it difficult to breathe. COPD is the third leading cause of death in the U.S., with more than 15 million people currently living with the disease, according to the American Lung Association.

Many people who have COPD suffer from hypercapnia, the retention of carbon dioxide -- a waste product of metabolism normally expelled by the lungs as a person breathes. This may lead to acute respiratory failure and hospitalization. One treatment for chronic hypercapnia is noninvasive ventilation, or a machine with a mask that helps to improve breathing.

Michael Wilson, M.D., a pulmonary and critical care physician at Mayo Clinic, led the study, which was funded by the Agency for Healthcare Research and Quality under a contract with the Mayo Clinic Evidence-Based Practice Center.

"Although there is ample evidence supporting in-hospital use of breathing devices such as BiPAP, until now, we didn't know which benefits may be available when we send people home with a new piece of equipment," says Dr. Wilson. "There were indications that at-home therapy might be beneficial, but there were conflicting studies and guidelines as to what would be best for our patients."

He and his colleagues wanted to determine the best practice, collecting and summarizing all available medical knowledge surrounding the topic.

To that end, the team conducted a meta-analysis, combing all available peer-reviewed and other expert literature for relevant randomized clinical trials and comparative observational studies.

After reviewing more than 6,300 citations, the researchers found 33 studies evaluating outcomes for 51,085 patients with COPD and hypercapnia who were followed for at least one month while using a noninvasive ventilator at home during nighttime sleeping hours.

Among these patients, use of a noninvasive ventilator device, such as bilevel positive airway pressure, compared to no device was significantly associated with lower mortality: 29.2% versus 22.3%. The use of a noninvasive ventilator device also led to fewer emergency department visits and hospitalizations, and lower rates of intubation if patients were admitted to the hospital.

"While there does seem to be some clear benefits to using devices such as BiPAP, we should be cautious as the studies included a lot of different types of patients with COPD. And many of the studies we evaluated were low or moderate in quality," says Dr. Wilson. "We still have a lot more to learn about which machine settings are best for different types of patients. In addition, although many studies in our review included quality of life measurements, we didn't see an improvement. While some studies showed better quality of life, other studies showed no difference. Again, this points to the importance of needing to more carefully evaluate which patients with COPD may receive benefit."

"Patients with COPD should talk with their physicians to determine whether a breathing device such as a BiPAP machine might be a good choice for them," he says. "For many patients, such a device may offer important benefits."
-end-
The senior author of the study is Zhen Wang, Ph.D., associate director of the Mayo Clinic Evidence-Based Practice Research Program. This project also was supported by the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, in which Dr. Wang holds a leadership role in knowledge synthesis research and Dr. Wilson is a Kern Scholar Program alumnus.

About Mayo Clinic

Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news and An Inside Look at Mayo Clinic for more information about Mayo.

Media contact:

Emily Blahnik, Mayo Clinic Public Affairs, 507-284-5005, newsbureau@mayo.edu

Mayo Clinic

Related Copd Articles:

COPD as a lung stem cell disease
Two internationally renowned stem cell researchers at the University of Houston have found an abundance of abnormal stem cells in the lungs of patients who suffer from Chronic Obstructive Pulmonary Disease (COPD), a leading cause of death worldwide.
New hope for COPD patients possible with in-home device
In a new paper published Feb. 4 in JAMA, Mayo Clinic researchers describe the benefits of in-home noninvasive ventilation therapy, which includes a type referred to as bilevel positive airway pressure, or BiPAP -- for many patients with chronic obstructive pulmonary disease (COPD).
COPD appears to cause more severe symptoms in women
Women who develop COPD report smoking fewer cigarettes than men; and yet, women experience greater breathing impairments, are subjected to more acute exacerbations of symptoms and report lower quality of life than men with the disease, according to research presented at ATS 2019.
African-Americans with COPD appear less likely to use pulmonary rehab
African-American patients with chronic obstructive pulmonary disease, or COPD, are less likely to participate in pulmonary rehabilitation programs than white patients, even when there are programs nearby.
COPD and type 2 diabetes
COPD and type 2 diabetes are two highly prevalent global health conditions associated with high mortality and morbidity.
Number of nonsmokers with COPD on the rise
The global burden of COPD is high, and prevalence of nonsmokers with COPD has been increasing.
Flu vaccination keeps COPD patients out of the hospital
A new study published in the January issue of CHEST® establishes that patients with chronic obstructive pulmonary disease (COPD) face heightened risks of death, critical illness, and hospitalization if they develop the flu and demonstrates the beneficial effects of influenza vaccination.
Kidney disease biomarker may also be a marker for COPD
A commonly used biomarker of kidney disease may also indicate lung problems, particularly COPD, or chronic obstructive pulmonary disease, according to new research published online in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.
COPD-associated inflammation halted in model experiment
Chronic obstructive pulmonary disease, or COPD for short, is believed to be the third most common cause of death worldwide.
Study: Almost 100 million adults have COPD in China
Chronic obstructive pulmonary disease (COPD) is widespread in China with 8.6 percent of the country's adult population -- almost 100 million people -- suffering from the chronic lung disease, according to a new Tulane University study published in The Lancet.
More COPD News and COPD Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Clint Smith
The killing of George Floyd by a police officer has sparked massive protests nationwide. This hour, writer and scholar Clint Smith reflects on this moment, through conversation, letters, and poetry.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Dispatch 6: Strange Times
Covid has disrupted the most basic routines of our days and nights. But in the middle of a conversation about how to fight the virus, we find a place impervious to the stalled plans and frenetic demands of the outside world. It's a very different kind of front line, where urgent work means moving slow, and time is marked out in tiny pre-planned steps. Then, on a walk through the woods, we consider how the tempo of our lives affects our minds and discover how the beats of biology shape our bodies. This episode was produced with help from Molly Webster and Tracie Hunte. Support Radiolab today at Radiolab.org/donate.