The benefit of non-invasive ventilation [NIV] in stable chronic obstructive pulmonary
disease [COPD] remains controversial. However, there is increasingly more evidence of NIV
efficiency, especially high-flow NIV. This review presents the old and the new evidence of NIV
effectiveness in stable COPD, considering pathophysiological arguments for NIV in COPD.
Guidelines, randomized controlled trials [RCTs] and crossover studies included in review and metaanalysis
based on patient-reported outcomes [PROs] have been analyzed. The role of NIV in
rehabilitation and in palliative care and the role of telemedicine in relation with NIV are still up for
debate. Challenges in choosing the right device and the optimal mode of ventilation still exist. There
are also discussions on the criteria for patient inclusion and on how to meet them. More studies are
needed to determine the ideal candidate for chronic NIV and to explain all the benefits of using NIV.
Keywords: COPD, NIV, pulmonary rehabilitation, telemedicine, ventilation
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