Noninvasive ventilation in chronic obstructive pulmonary disease (COPD) with chronic respiratory failure

Due to the steadily increasing number of patients with chronic obstructive pulmonary disease (COPD), the number of those with very advanced stages of the disease is also steadily increasing. Particularly in severe COPD, respiratory insufficiency occurs in the course of the disease, which by affection of the respiratory pump can become clinically evident as respiratory failure with subsequent hypercapnia. In chronic hypercapnic insufficiency non-invasive ventilation via face masks is the treatment of choice; however, an improvement of the mortality and prolonged hospitalization-free survival can only be achieved if the ventilation treatment is initiated with the aim of normocapnia or the maximum possible reduction of the partial pressure of carbon dioxide in arterial blood. This high intensity ventilation is now recommended in national and international guidelines and is the current standard treatment in COPD with chronic hypercapnic respiratory insufficiency.