[Noninvasive ventilation: current concepts in the treatment of chronic respiratory failure in patients with chronic obstructive lung disease].

Long-term oxygen therapy remains the mainstay treatment for advanced-stage chronic obstructive pulmonary disease that has reached the state of chronic respiratory failure. Noninvasive ventilation should be discussed for some patients with a instability and frequent hospitalizations for decompensation and progressive degradation of blood gases. Although this subpopulation remains to be perfectly defined, it is reasonable to discuss the implementation of noninvasive ventilation at night in association with daytime oxygen therapy for patients who do not respond to well conducted and well-implemented oxygen therapy if the disease instability is marked by an increasing rate of hospitalizations for decompensation. This subpopulation includes COPD patients with a worsening PaCO2 above 50 mmHg.