People with severe lung disease could have a much better quality of life thanks to a clinical trial carried out by UK experts led by a team from the Lane Fox Respiratory Service based at St Thomas' Hospital and presented at the British Thoracic Society Winter Meeting.
The research shows, for the first time, that combining Home Mechanical Ventilation (HMV) - a mask breathing machine used in the home, with Home Oxygen Therapy (HOT) reduces the chance of readmission to hospital within 28 days and the frequency of exacerbation, or 'flare-up', experienced over 12 months in patients with severe chronic obstructive pulmonary disease (COPD). Indeed, the research also showed that the patients had fewer admissions over the 12 months following initiation of treatment.
The 'HOT-HMV' mask ventilator machine works by blowing in air and oxygen to keep oxygen levels high, and carbon dioxide (the waste gas) levels low.
COPD is the name for a group of lung diseases that narrow the airways causing breathing difficulties. The illness inflicts a huge toll on patients, their carers, and on the NHS. In total, 1.2 million people in the UK have been diagnosed with COPD. There are 30,000 deaths from the disease in the UK each year.
The randomised controlled trial was conducted amongst 116 patients with persistent hypercapnia (abnormally elevated carbon dioxide levels in the blood) 2-4 weeks after the resolution of acute acidosis (increased acidity in the blood) - a key symptom of worsening COPD. Patients were randomised to either HOT or HOT and HMV treatment. Follow up was undertaken over a 12 month period.
Commenting on the research, Professor Nicholas Hart, Clinical Director of the Lane Fox Respiratory Service at St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, who co-ordinated the trial, said:
"COPD places huge pressures on patients, NHS and society - especially during the Winter, when flare-ups can be more common. We see over 1,000 patients admitted with COPD each year here at Guy's and St Thomas'.
"What's exciting about our research is that it shows, for the first time, that combining oxygen treatment with the HMV ventilator device at home, can cut the likelihood of readmission to hospital by almost 50% at 28 days and 30% at 12 months."
Dr Lisa Davies, Consultant Respiratory Physician at Aintree University Hospital and Chair of the British Thoracic Society Board, added:
'This novel research shows how we can help people with the most severe COPD avoid flare-ups and stay out of hospital. It's an excellent example of a practical, cost-effective way to improve patients' quality of life and save stretched NHS resources.'
The trial will continue with patient survival rates being monitored over the next three and five years.
Funding and equipment for the trial have been provided by manufacturers Philips-Respironics and ResMed, and Guy's and St Thomas' Charity.