Non-invasive ventilation in the palliative care of patients with chronic obstructive pulmonary disease: a scoping review protocol

Steindal, Simen Alexander; Hofsø, Kristin; Aagaard, Hanne; Mariussen, Kari Larsen; Andresen, Brith; Christensen, Vivi Lycke; Heggdal, Kristin; Karlsen, Marte‐Marie Wallander; Kvande, Monica Evelyn; Kynø, Nina Margrethe; Langerud, Anne Kathrine; Ohnstad, Mari Oma; Sørensen, Kari; Larsen, Marie Hamilton

doi:10.1136/bmjopen-2020-048344

Cited by 12 publications

(7 citation statements)

References 32 publications

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“…However, little is known about how the use of the devices relieves symptoms, and how they are used by the patients in the very end stage of the disease. In a published protocol from 2021, Steindal et al describes an intended scoping review of the effect of LT-NIV on symptoms in COPD palliative care, the outcome of which is not yet published [ 32 ]. Duarte et al underline the lack of evidence on the effect of both LT-NIV and LT-HFNC in end-stage treatment of COPD patients, and emphasize the potential advantages of LT-HFNC as it may be used during eating and talking, both activities that may cause dyspnea in end-stage COPD [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

A Real-Life Study of Combined Treatment with Long-Term Non-Invasive Ventilation and High Flow Nasal Cannula in Patients with End-Stage Chronic Obstructive Lung Disease

Weinreich,

Storgaard

2023

JCM

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Patients with end-stage chronic obstructive pulmonary disease (COPD) often develop persistent hypoxic or hypercapnic respiratory failure, or a combination of both. Ventilatory support, in terms of a long-term high-flow nasal cannula (LT-HFNC) and long-term non-invasive ventilation (LT-NIV), may be indicated. Often, clinicians choose either one or the other. This paper explores combined treatment with LT-HFNC and LT-NIV in a real-life setting. In total, 33 patients with COPD and persistent respiratory failure were included in this study. Of those, 17 were initiated on LT-HFNC and used it for 595 (374) days and 16 were initiated on LT-NIV and used it for 558 (479) days. On average, patients used respiratory support continuously for 908 (586) days. Baseline characteristics were comparable, apart from PaCO2 at first ventilatory support initiation (LT-HFNC/LT-NIV 7.1 (1.1) kPa/8.8 (0.9) kPa respectively (p = 0.002)). Both groups experienced a reduction in hospitalizations in the first twelve months after treatment initiation, compared to the twelve months before (LT-HFNC p = 0.022 and LT-NIV p = 0.014). In total, 25% of LT-NIV patients stopped treatment after HFNC initiation due to intolerance and 59% stopped LT-HFNC treatment 126 (36) days after LT-NIV initiation as monotherapy was sufficient. In 44% of these patients, LT-HFNC was re-initiated at the end of life. At the time of analysis, 70% of patients had died. In the last three months of life, patients stopped using LT-NIV, whereas 91% used LT-HFNC. In conclusion, the combined use of LT-NIV and LT-HFNC reduced hospitalizations in patients with COPD and persistent respiratory failure. The study indicates that LT-HFNC is well tolerated, and better tolerated than LT-NIV at the very end stages of COPD.

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Section: Discussionmentioning

confidence: 99%

A Real-Life Study of Combined Treatment with Long-Term Non-Invasive Ventilation and High Flow Nasal Cannula in Patients with End-Stage Chronic Obstructive Lung Disease

Weinreich,

Storgaard

2023

JCM

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“…The reporting of the review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews checklist [ 32 ]. Deviations from the published protocol [ 33 ] are described in Additional file 1 .…”

Section: Methodsmentioning

confidence: 99%

Non-invasive ventilation in the care of patients with chronic obstructive pulmonary disease with palliative care needs: a scoping review

Steindal,

Hofsø,

Aagaard

et al. 2024

BMC Palliat Care

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Background Patients with severe chronic obstructive pulmonary disease (COPD) could have palliative care (PC) needs because of unmet needs such as dyspnoea. This may lead to anxiety and may have an impact on patients’ ability to perform daily activities of living. PC can be started when patients with COPD have unmet needs and can be provided alongside disease-modifying therapies. Non-invasive ventilation (NIV) could be an important measure to manage dyspnoea in patients with COPD in need of PC. A scoping review was conducted to gain an overview of the existing research and to identify knowledge gaps. The aim of this scoping review was to systematically map published studies on the use of NIV in patients with COPD with PC needs, including the perspectives and experiences of patients, families, and healthcare professionals (HCPs). Methods This review was conducted following the framework of Arksey and O’Malley. The reporting of the review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. The review protocol was published. AMED, CINAHL, Embase, MEDLINE, PEDro, and PsycInfo were searched from inception to November 14, 2022. The included studies had to report the perspectives and experiences of COPD patients, relatives, and HCPs regarding NIV in the care of patients with COPD with PC needs. In pairs, the authors independently assessed studies’ eligibility and extracted data. The data were organised thematically. The results were discussed in a consultation exercise. Results This review included 33 papers from 32 studies. Four thematic groupings were identified: preferences and attitudes towards the use of NIV; patient participation in the decision-making process of NIV treatment; conflicting results on the perceived benefits and burdens of treatment; and heterogenous clinical outcomes in experimental studies. Patients perceived NIV as a ‘life buoy’ to keep them alive. Many patients wanted to take part in the decision-making process regarding NIV treatment but expressed varying degrees of inclusion by HCPs in such decision-making. Conflicting findings were identified regarding the perceived benefits and burdens of NIV treatment. Diversity in heterogeneous clinical outcomes were reported in experimental studies. Conclusions There is a need for more studies designed to investigate the effectiveness of NIV as a palliative measure for patients with COPD with PC needs using comprehensive outcomes. It is especially important to gain more knowledge on the experiences of all stakeholders in the use of home-based NIV treatment to these patients.

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“…Dyspnoea is a multifactorial and limiting symptom that can be addressed through non-invasive ventilation, which can be used for patients with COPD as a palliative measure, according to a scoping review addressed by Steindal et al [96].…”

Section: Advanced Interventions and Symptom Managementmentioning

confidence: 99%

ERS International Congress 2023: highlights from the Allied Respiratory Professionals Assembly

Jacinto,

Smith,

Diciolla

et al. 2023

ERJ Open Res

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This paper summarises some of the outstanding sessions that were (co)organised by the Allied Respiratory Professionals Assembly during the 2023 European Respiratory Society (ERS) International Congress. Two sessions from each Assembly group are outlined in the present paper, covering the following topics: Group 9.1 focuses on respiratory physiology techniques, specifically on predicted values and reference equations, device development and novel applications of cardiopulmonary exercise tests; Group 9.2 presents an overview of the talks given at the mini-symposium on exercise training, physical activity and self-management at home and outlines some of the best abstracts in respiratory physiotherapy; Group 9.3 highlights the nursing role in global respiratory health and presents nursing interventions and outcomes; and Group 9.4 provides an overview of the best abstracts and recent advances in behavioural science and health psychology. This Highlights paper provides valuable insight into the latest scientific data and emerging areas affecting the clinical practice of Allied Respiratory Professionals.

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Non-invasive ventilation in the palliative care of patients with chronic obstructive pulmonary disease: a scoping review protocol

Cited by 12 publications

References 32 publications

A Real-Life Study of Combined Treatment with Long-Term Non-Invasive Ventilation and High Flow Nasal Cannula in Patients with End-Stage Chronic Obstructive Lung Disease

A Real-Life Study of Combined Treatment with Long-Term Non-Invasive Ventilation and High Flow Nasal Cannula in Patients with End-Stage Chronic Obstructive Lung Disease

Non-invasive ventilation in the care of patients with chronic obstructive pulmonary disease with palliative care needs: a scoping review

ERS International Congress 2023: highlights from the Allied Respiratory Professionals Assembly

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