To explain the rationales for home noninvasive ventilation (NIV) in chronic obstructive pulmonary disease (COPD) patients.
To review available evidence on the use of home NIV in COPD patients.
To review the current consensus on the indications for home NIV in COPD patients.
To describe recent evidence in support of home NIV in a selected group of severe COPD patients.
To outline future research directions in this area.
Summary NIV is now considered the standard care for COPD patients with hypercapnic exacerbations of their disease. There are theoretical benefits of long-term NIV in COPD patients, but evidence from randomised controlled trials (RCTs) is conflicting and inconclusive. This article will address the following issues:
• What are the physiological and clinical rationales for the use of home NIV in COPD patients?
• What is the available evidence on the use of home NIV in COPD patients?
• What are the limitations of previous studies performed in this area?
• Recent advances in home NIV.
• Future directions.