Using Ventilator to Control Oxygen May Be COPD Game-changer, Study Suggests

Using a ventilator to control the level of supplemental oxygen a chronic obstructive pulmonary disease (COPD) patient receives halved patients’ trips to the hospital from disease flare-ups, according to a clinical trial.

Britishers researchers conducted the study, which they dubbed the Home Oxygen Therapy-Home Mechanical Ventilation (HOT-HMV) trial (NCT00990132). The team that led the research was from the Lane Fox Respiratory Service at the London academic science center Guy’s and St Thomas.

A ventilator is a device that supports a patient’s breathing.

The British study, “Effect of Home Noninvasive Ventilation With Oxygen Therapy vs Oxygen Therapy Alone on Hospital Readmission or Death After an Acute COPD Exacerbation, A Randomized Clinical Trial,” was published in the Journal of the American Medical Association.

Using a ventilator to control the supplemental oxygen patients receive at home lengthened the time it took for them to be admitted to a hospital after a COPD flare-up known as an acute exacerbation, the trial showed.

The researchers presented the study’s results at the American Thoracic Society’s annual conference in Washington, which started May 19 and ends May 24.

Professors Nicholas Hart and Patrick Murphy of St Thomas Hospital said the findings could lead to a major change in the way that the most severely affected COPD patients receive treatment.

“The only current treatment we have to give these patients is oxygen therapy, but now we can give them oxygen as well as a ventilator in their home,” Hart said in a press release. “We have managed to reduce the likelihood of readmission to hospital by almost 50%. In the trial we used a home ventilator that co-ordinates itself with the individual patient’s breathing. The mask ventilator machine works by blowing in air and oxygen to keep oxygen levels high and carbon dioxide, the waste gas, low.”

The team will continue the study for three to five years to see how the ventilator-oxygen combination works over the long term.

“These results are extremely promising but the work will continue,” Hart said. “So far we have found that patients using home oxygen with a home ventilator device are two-thirds less likely to be readmitted within 28 days. This is very important because not only does it maintain a patient’s quality of life but also it has the potential to significantly increase our ability to care for these patients without the need for a hospital stay.

“At Guy’s and St Thomas, around 1,000 patients are admitted each year with COPD,” he said. “If we can keep them comfortable at home for longer, this will have a big impact.”

The World Health Organization predicts that COPD will be the world’s third most life-threatening disease by 2030.