The long-term efficacy of domiciliary noninvasive positive pressure ventilation in COPD: A meta-analysis of randomized controlled trials.

We aimed to evaluate the long-term use or effects of domiciliary non-invasive positive pressure ventilation (NIPPV) used to treat patients with chronic obstructive pulmonary disease (COPD). Databases were searched to identify randomized controlled trials (RCTs) of COPD with NIPPV for longer than 1 year. The primary outcome as mortality rates were accessed in this meta-analysis. The eight trials included in this study comprised data from 913 patients. The mortality rates for the NIPPV and control groups were 29% (118/414) and 36% (151/419); this difference was statistically significant (risk ratio (RR): 0.79, 95% confidence interval (CI): 0.65-0.95). Mortality rates were reduced with NIPPV in four trials that included stable COPD patients. There was no difference in admission, acute exacerbation and quality of life (QOL) between the NIPPV and control groups. There was no significant difference in withdrawal rates between the two groups (RR 0.99, 95% CI 0.72-1.36, p = 0.94). Maintaining long-term nocturnal NIPPV for more than 1 year in COPD patients, especially stable status COPD patients, leads to a decrease in the mortality rate, and the withdrawal rate is not high compared to long term oxygen treatments.