Non-invasive ventilation in chronic obstructive pulmonary disease
Mechanically assisted ventilation in COPD 210
Negative pressure ventilation 210
Positive pressure ventilation via tracheostomy 211
Nasal positive pressure ventilation 211
Practical problems speciﬁc to patients with COPD 215
Long-term oxygen therapy (LTOT) is the only therapy which has been shown to improve survival in patients with respiratory failure because of chronic obstructive pulmonary disease (COPD).1,2 It is the ﬁrst-line treatment for such patients, but it is reasonable to explore alternatives. Drug therapy has been disappointing, but with the excellent results of non-invasive positive pressure ventilation (NIV) in patients with neuromuscular disease and chest wall deformity3,4 increasingly attention has focused on the numerically much larger group of patients with COPD. There are a number of theoretical reasons why NIV may confer an additional advantage.