The use of long-term noninvasive ventilation (NIV) to benefit patients with severe chronic obstructive pulmonary disease (COPD) has long been controversial. Dating back to the 1960s, clinicians speculated that intermittent respiratory muscle rest afforded by negative pressure ventilators might benefit daytime respiratory muscle performance of patients with severe COPD.1 However, use of this approach was generally abandoned in the early 1990s when a large randomized clinical trial using a “jacket” negative pressure ventilator nocturnally showed no improvement in exercise endurance or respiratory muscle strength in patients with severe COPD, and acceptance of the device by patients was poor.2
Hill NS, Ugurlu AO. Home Noninvasive Ventilation to Reduce Readmissions for Chronic Obstructive Pulmonary Disease. JAMA. 2017;317(21):2167–2169. doi:10.1001/jama.2017.5226
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