Long-term home high intensity non-invasive ventilation (HINIV) can improve respiratory performance in patients with chronic obstructive pulmonary disease (COPD) and hypercapnic chronic respiratory failure (HCRF), finds a recent study. The latest research by a team of scientists from Octubre University Hospital, Madrid, Spain, found that long term HINIV improves respiratory performance for patients by improving the function of the diaphragmatic musculature. The study, published in International Journal of Chronic Obstructive Pulmonary Disease,    analyzed 30 patients and observed that the 12 months of HINIV, showed significant increases in FVC of 9.2% (p = 0.002), FEV1 of 3.5% (p = 0.04), MIP of 9.4% (p = 0.006), and 6-minute-walking test (6MWT) of 31.9 m (p = 0.001). The researchers highlighted that in patients with very severe chronic obstruction to airflow, hypercapnia and pulmonary hyperinflation, HINIV decreases hypercapnia, increases quality of life, and improves the outcomes of respiratory function tests in a statistically significant way. This improvement is probably attributable to the strengthening of the respiratory musculature, as suggested by the results of increased FVC, MIP, and thickening fraction of the diaphragm.