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COPD is common and respiratory failure due to COPD is an increasingly common disorder. Use of non-invasive positive pressure ventilation (NPPV) for patients with respiratory failure due to exacerbatons of COPD. Several trials and…

1. Your Nomination - Please briefly describe in your own words the question about a health care test or treatment that interests or concerns you:

COPD is common and respiratory failure due to COPD is an increasingly common disorder.

Use of non-invasive positive pressure ventilation (NPPV) for patients with respiratory failure due to exacerbatons of COPD. Several trials and systematic reviews/meta-analyses indicate that when used in research settings, NPPV early in the course of treatment improves healthcare utilization, mortality, and reduces costs comapred to standard care in which intubation and mechanical ventilation is used as the primary strategy of respiratory support. Whether such benefits accrue in real world settings with typical providers, average patients is less clear. Use of NPPV requires adequate staff and physician training and can lead to complications (e.g., aspiration, delays in appropriate care) Use of NPPV also requires intensive patient monitoring and support, which may not be available in clinical settings.

2. Why do you think your question is important? (you may select more than one category if appropriate)
 My question relates to a very common disease or problem
 People with this disease or problem have considerable health or financial hardships
 There is uncertainty about how well the test, treatment, or intervention works
 There is significant potential for side effects/harms using this test, treatment, or intervention
 Funding of this test, treatment, or intervention is uncertain or variable
 There is unequal access or application of this health care intervention across providers
 There is potential for cost savings from better information on this subject
 This is a new technology/development
 There is new evidence of clinical and/or cost effectiveness for this test, treatment, or intervention
 Other
3. What illness or health condition is related to your question? (You can also specify a particular health-promoting activity, such as breast-feeding)
Respiratory failure from COPD
4. What group(s) or patients does your question apply to?
Adults, particularly older adults with COPD, a group at higher risk of respiratory failure.
5. What is the specific purpose of the health care test or treatment you have a question about? (mark all that you think apply)
Identification of a disease or condition:
 Screening or diagnosis/identification for a particular disease, or risk assessment for a disease
 Risks or harms that can come from a disease identification tool or test
 Diagnostic tests and tools
 Diagnosis of co-occurring diseases
 Intervention (such as a drug treatment, therapy, device)
 Management of a condition or particular system of care
 Delivery of a health service
 Referral
 Risks or harms associated with treatment of a disease or condition
 Prevention or health promotion
 Specific population health concerns, such as ethnic group or gender
 Other
 Dont know
6. Does your question include a comparison of different health care approaches?
No
If yes, please list what you would like to see compared:
Non-invasive vs. invasive positive pressure ventilation.
7. Desired Health Improvements: If you question focuses on:
Identification of a particular disease or condition, what improvements in identification or diagnosis would you like to see?


Treatment of a particular disease or condition, what improvements in patient symptoms or problems would you like to see? Health care utilization (length of hospital stay, health care costs, number of ventilator-free days, discharge to home rather than to another health care facility) Mortality Patient comfort
8. Harms: Are there risks, side effects, or harms you are concerned about? If yes, please specify what those are:
Aspiration pneumonia Aspiration Facial skin ulceration
9. Based on your answers to the previous questions, what research question(s) would you like to have answered?
What is the comparitive effectiveness of non-invasive vs. invasive positive pressure ventilation in patients with respiratory failure from COPD?
10. Are there health-care focused, disease-focused, or patient-focused organizations that you see as being relevant to this issue? Who do you think we should contact as we consider your nomination?
American Thoracic Society American College of Chest Physicians Society for Critical Care Medicine Insurers
11. Other Information About You (OPTIONAL) In order to help us understand the context of your health care question, it would be helpful to know more about you. The answers you give will not influence the progress of your suggestion. Thank you.
a. Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)
Physician

b. Is there any other information about you that is relevant to your question?


c. Are you making a suggestion as an individual or on behalf of an organization?
 Individual
 Organization

Project Timeline

Noninvasive Positive-Pressure Ventilation (NPPV) for Acute Respiratory Failure

Dec 29, 2010
Topic Initiated
Apr 21, 2011
Jul 11, 2012
Page last reviewed November 2017
Page originally created March 2008

Internet Citation: COPD is common and respiratory failure due to COPD is an increasingly common disorder. Use of non-invasive positive pressure ventilation (NPPV) for patients with respiratory failure due to exacerbatons of COPD. Several trials and…. Content last reviewed November 2017. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD.
https://effectivehealthcare.ahrq.gov/get-involved/nominated-topics/copd-is-common-and-respiratory-failure-due-to-copd-is-an-increasingly-common-disorder-use-of-non-invasive-positive-pressure-ventilation-nppv-for-patients-with-respiratory-failure-due-to-exacerbatons-of-copd-several-trials-an

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