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We read with interest the comprehensive review on home noninvasive ventilation (NIV) for COPD by Dr Orr and the expert discussion that followed.1 We believe that an important part of the delivery of this effective treatment is the appropriate selection of the mechanical ventilation mode.
For almost 2 decades, the data on the use of domiciliary NIV for patients with COPD with chronic hypercapnic respiratory failure were simply disheartening. In 2013, Struik and colleagues2 published online a meta-analysis on 7 randomized controlled trials that revealed that the intervention was beneficial for a subgroup of subjects who had higher PaCO2 at baseline (≥ 55 mm Hg), who used nocturnal NIV > 5 h/night, and with high inspiratory positive airway pressure (≥ 18 cm H2O). The clinical trials that followed adopted this general ventilation strategy, …
Correspondence: Umur Hatipoğlu MD MBA, 9500 Euclid Avenue A-90, Cleveland, Ohio, 44195. E-mail: hatipou{at}ccf.org
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