Abstract
Background and aim Little is known about the current use of long-term home non-invasive ventilation (LTHNIV) in restrictive thoracic diseases (RTD), including chest wall and neuromuscular disorders (CWD, NMD). This study aimed to capture the pattern of LTHNIV in RTD patients via a web-based international survey.
Methods The survey involved ERS Assembly 2.02 (NIV dedicated group) October-December 2019.
Results 166/748 (22.2%) members from 41 countries responded; 80% were physicians, of whom 43% worked in a respiratory intermediate intensive care unit (RIICU). The NMD:CWD ratio was 5:1, Amyotrophic lateral sclerosis (ALS) being the most frequent indication within NMD (78%). The main reason to initiate LTHNIV was diurnal hypercapnia (71%). Quality of life/sleep was the most important goal to achieve. In 25% of cases, clinicians based their choice of the ventilator on patients’ feedback. Among NIV-modes, pressure support ventilation spontaneous-timed (PSV-ST) was the most frequently prescribed for day and night-time. Mouthpieces were the preferred daytime NIV interface, whereas oro-nasal masks the first choice overnight. Heated humidification was frequently added to LTHNIV (72%). Single-limb circuits with intentional leaks (79%) were the most frequently prescribed. Follow-up was most often provided in an outpatient setting.
Conclusions This ERS survey illustrates physicians’ practices of LTHNIV in RTD patients. NMD and, specifically, ALS were the main indications for LTHNIV. NIV was started mostly because of diurnal hypoventilation with a primary goal of patient-centred benefits. Bi-level PSV-ST and oro-nasal masks were more likely to be chosen for providing NIV. LTHNIV efficacy was assessed mainly in an outpatient setting.
Footnotes
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Conflict of interest: Dr. PIERUCCI has nothing to disclose.
Conflict of interest: Dr. Dr. Crimi has nothing to disclose.
Conflict of interest: Dr. Dr. Carlucci has nothing to disclose.
Conflict of interest: Dr. Dr. Carpagnano has nothing to disclose.
Conflict of interest: Dr. Dr. Janssens has nothing to disclose.
Conflict of interest: Dr. Dr. Luján has nothing to disclose.
Conflict of interest: Dr. Noto has nothing to disclose.
Conflict of interest: Dr. Dr. wijkstra reports grants and personal fees from Philips, grants and personal fees from RESMED, grants from Goedegebuure, grants from vital air, personal fees from Bresotec, personal fees from synapse, outside the submitted work;.
Conflict of interest: Dr. Dr. Windisch reports grants from Weinmann/Germany, grants from Vivisol/Germany, grants from Heinen und Löwenstein/Germany, grants from VitalAire/Germany, grants from Philips/Respironics/USA, during the conduct of the study; personal fees from Companies dealing with mechanical ventilation, outside the submitted work;.
Conflict of interest: Dr. Scala has nothing to disclose.
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- Received December 4, 2020.
- Accepted January 21, 2021.
- ©The authors 2021
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