Abstract
Background Noninvasive ventilation (NIV) improves survival and quality of life in amyotrophic lateral sclerosis (ALS) patients. NIV initiation is mostly conducted at hospital, but a recurrent lack of hospital beds led to the necessity to explore an at-home initiation process. We report here data from our NIV initiation cohort in ALS patients.
Research Question Could, our at-home NIV initiation process with telemonitoring in ALS patients, be an efficient solution for adherence and nocturnal hypoxemia correction?
Methods We performed a retrospective analysis of data collected from the 265 ALS patients followed in the Bordeaux ALS Centre for whom NIV initiation has been carried out between September 2017 and June 2021 with two modalities: at-home initiation or in-hospital initiation. The primary outcome was adherence to NIV at 30 days. The secondary outcome was at-home NIV initiation process efficiency on nocturnal hypoxemia correction.
Results At 30 days, NIV adherence (mean >4 h·day−1) was 66% in total population, 70% in the subgroup at-home NIV initiation and 52% in the subgroup in-hospital NIV initiation. Nocturnal hypoxemia correction was observed in 79% of adherent patients in the subgroup at-home NIV initiation. Mean delay of NIV prescription and at-home NIV initiation was 8.7 days (+/- 6.5) versus 29,5% at hospital.
Conclusion Our study shows that our at-home NIV initiation process in ALS patients is a good option to provide rapid access to NIV with good adherence and efficiency. Further literature on at-home NIV initiation benefit is welcomed especially to evaluate long-term efficiency and global cost analysis.
Footnotes
This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.
Conflict of interest: Thomas Réginault reports support for the present manuscript from Bordeaux University Foundation; travel support from Vivisol; personal fees from Zéphyr paramed; outside the submitted work.
Conflict of interest: Benoit Bouteleux reports personal fees from Zéphyr paramed, outside the submitted work.
Conflict of interest: Philippe Wibart reports support for the present manuscript from Bordeaux University Foundation; personal fees from Zéphyr paramed; outside the submitted work.
Conflict of interest: All other authors have nothing to disclose.
This is a PDF-only article. Please click on the PDF link above to read it.
- Received August 29, 2022.
- Accepted November 20, 2022.
- Copyright ©The authors 2022
This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions{at}ersnet.org