Researchers studying late failure of noninvasive ventilation in hospitalized patients suffering COPD exacerbations found that certain risk factors were tied to NIV failure, but that transitioning these patients that fail NIV to invasive ventilation could reduce mortality.

According to the results, the risk factors for late NIV failure after 48 hours of treatment in COPD patients with acute exacerbation were the occurrence of in-hospital pneumonia, high heart rate before NIV, the presence of acidosis, the level of consciousness, and inefficient blood oxygenation after one to two hours of NIV. 

“In addition, late failure of NIV was associated with increased hospital mortality,” the researchers wrote. “Therefore, early intubation [within 24 hours of NIV] is an alternative to reduce mortality.”