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Home breathing device reduces COPD admissions

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Patients with chronic obstructive pulmonary disease could have a much better quality of life thanks to a clinical trial involving a home breathing device that has been shown to reduce exacerbations.

Combining home mechanical ventilation – a mask breathing machine used in the home, with home oxygen therapy reduced the risk of readmission to hospital within 28 days and the frequency of exacerbation experienced over 12 months in patients with severe COPD.

“COPD places huge pressures on patients, NHS and society”

Nicholas Hart

In fact, the research also showed that the patients had fewer admissions over the 12 months following initiation of treatment.

The “HOT-HMV” mask ventilator machine works by blowing in air and oxygen to keep oxygen levels high, and carbon dioxide levels low.

The trial was led by a team from the Lane Fox Respiratory Service based at St Thomas’ Hospital in London and presented at the British Thoracic Society’s winter meeting today.

It was conducted among 116 patients with persistent hypercapnia –abnormally elevated carbon dioxide levels in the blood – two to four weeks after the resolution of acute acidosis – increased blood acidity – which is a key symptom of worsening COPD.

Patients were randomised to either HOT or HOT and HMV treatment. Follow up was undertaken over a 12-month period.

“It’s an excellent example of a practical, cost-effective way to improve patients’ quality of life”

Lisa Davies

Professor Nicholas Hart, clinical director of the Lane Fox Respiratory Service at St Thomas’ Hospital, Guy’s and St Thomas’ NHS Foundation Trust, co-ordinated the trial.

He said: “COPD places huge pressures on patients, NHS and society – especially during the winter, when flare-ups can be more common. We see over 1,000 patients admitted with COPD each year here at Guy’s and St Thomas’.

“What’s exciting about our research is that it shows, for the first time, that combining oxygen treatment with the HMV ventilator device at home, can cut the likelihood of readmission to hospital by almost 50% at 28 days and 30% at 12 months,” he said.

Dr Lisa Davies, consultant respiratory physician at Aintree University Hospital and chair of the British Thoracic Society, added: “It’s an excellent example of a practical, cost-effective way to improve patients’ quality of life and save stretched NHS resources.”

The trial will continue with patient survival rates being monitored over the next three and five years.

Funding and equipment for the trial was provided by manufacturers Philips-Respironics and ResMed, and Guy’s and St Thomas’ Charity.

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Readers' comments (3)

  • Sounds like a nice thing to have. Unfortunately this article does not have any details and doesn't even explain the abbreviations used, a link to the details would have been helpful. I notice that this is a presentation at a conference, not a peer reviewed article being mentioned, as well as being a small study, presumably a pilot study to justify doing a large scale study which might give information that changes practice.

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  • Interested to know more about what the therapy actually is...this article is pretty vague!

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  • Home oxygen therapy and home mechanical ventilation..actually should be home non-invasive ventilation. The theory is that using home NIV helps to reduce the incidence of hypercapnia particularly where oxygen therapy is also required, therefore reducing admissions for type 2 respiratory failure. I work in a tertiary centre with a domiciliary NIV service, we are currently collating the data we have collected on our cohort of patients and hope to publish our findings, as there is very little data available on the treatment of more chronic patients as opposed to the acute episodes.

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