In this large retrospective analysis of patients hospitalized with acute COPD exacerbations with respiratory failure, the use of noninvasive ventilation increased from 14% to 16% from 2006 to 2008, but variation in use between hospitals was great (ranging from 0 to 100%, with a median of 11%). Noninvasive ventilation was associated with better outcomes than invasive ventilation, including lower inpatient mortality (risk ratio 0.54, CI 0.50 to 0.59), shorter LOS (-3.2 days, CI -3.4 to -2.9), lower hospital charges (-$35,012, CI -$36,848 to -$33,176), and fewer iatrogenic pneumothorax (0.05% vs 0.5%, p<0.001). Noninvasive ventilation is probably underutilized, and associated with better outcomes compared to invasive ventilation, in patients with acute COPD with respiratory failure (abstract).
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