Noninvasive positive pressure ventilation for respiratory failure caused by exacerbations of chronic obstructive pulmonary disease: a standard of care?

This editorial comments on a meta-analysis of the use of noninvasive positive pressure ventilation to treat patients with acute respiratory failure caused by chronic obstructive pulmonary disease (COPD) exacerbations published in the British Medical Journal earlier this year. Based on its analysis of seven randomized controlled trials that met pre-specified criteria, the meta-analysis demonstrated highly significant benefits of noninvasive positive pressure ventilation in COPD patients, including a reduction in a combined end-point consisting of death and endotracheal intubation. The editorial argues that, based on the strength of this and other evidence, noninvasive positive pressure ventilation to treat selected patients with acute respiratory failure due to COPD exacerbations should now be considered a standard of care.