We read with interest the “European Respiratory Society guidelines on long-term home non-invasive ventilation for management of COPD” [1]. In recent years, several studies have attempted to improve outcomes by using home non-invasive ventilation in patients with end-stage COPD who suffer from chronic hypercapnic respiratory failure (CHRF). As noted in the guidelines, the definition of “stable chronic hypercapnia” following an acute exacerbation has historically been ambiguous, which has probably contributed to the inconsistent findings across clinical trials of home non-invasive ventilation [2]. A time period of 2–4 weeks is required before a state of “stable chronic hypercapnia” is likely to be present following an acute COPD exacerbation http://bit.ly/2D4lOok

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COPD 患者“稳定的慢性高碳酸血症”的定义：生理学角度

我们饶有兴趣地阅读了“欧洲呼吸学会关于长期家庭无创通气治疗 COPD 的指南”[1]。近年来，一些研究试图通过对患有慢性高碳酸血症呼吸衰竭 (CHRF) 的终末期 COPD 患者使用家庭无创通气来改善结果。如指南中所述，急性加重后“稳定的慢性高碳酸血症”的定义历来含糊不清，这可能导致家庭无创通气临床试验结果不一致[2]。在 COPD 急性加重后可能出现“稳定的慢性高碳酸血症”状态需要 2-4 周的时间 http://bit.ly/2D4lOok