P134 Effectiveness of home non-invasive ventilation for persistently hypercapnic COPD patients

Abstract Introduction/Aim Approximately 25% of patients with GOLD stage 3 or 4 COPD have chronic hypercapnia with a daytime/awake PaCO2 >45mmHg. Persistent hypercapnia is associated with worse quality of life, increased frequency and severity of exacerbations, increased frequency and length of hospital presentations, increased need for invasive and non-invasive acute non-invasive ventilation (NIV) and increased mortality. Acute NIV is very effective at treating decompensated hypercapnic respiratory failure, but the role domiciliary NIV is less clear in those that remain persistently hypercapnic beyond their exacerbation. The aim of this study is to evaluate an existing cohort of severe COPD patients with chronic hypercapnia who were commenced on home NIV over a 5 year period and assess their outcomes. Methods We conducted a five-year retrospective audit of medical records of all patients commenced on home NIV in our institution between January 2017 to January 2023. Only patients who received a home NIV device with confirmed COPD, hypoventilation and chronic hypercapnia were considered for the study. Mortality was assessed at 12 months following NIV initiation. Rehospitalisation rates were assessed 12 month prior and following home NIV initiation. Additional analysis of demographical data, device settings and pressures used will be included for discussion. Results During the study period there were 189 patients identified that met the inclusion criteria. Ongoing data analysis is in progress… Conclusion The expected conclusions are that our cohort will include a significant proportion of OSA overlap patients, which is a higher risk demographic. This may largely be due to the funding available for subsided devices through the Queensland sleep disorders program. We anticipate a decrease in hospitalisation presentations. We also anticipate much lower pressures than those used in the literature.