Chest
Clinical InvestigationsNPPVChanging Patterns in Long-term Noninvasive Ventilation: A 7-Year Prospective Study in the Geneva Lake Area
Section snippets
Materials and Methods
As of October 1992, all patients treated by home NPPV in the cantons of Geneva and Vaud (1,030,000 inhabitants [year 2000 census]) were prospectively included in a computerized database. Patients with tracheostomies were not included in this analysis. In Switzerland, the use of tracheostomy for long-term PPV is very restrictive (at present, < 5% of patients receive HMV).
Patients were started on NPPV therapy either after an acute episode of hypercapnic respiratory failure or electively, due to
Patients
Between October 1, 1992 and February 1, 2000, 211 patients receiving home NPPV therapy were included in the study database. The length of follow-up ranged from 1 to 88 months (median, 24 months). Patients were divided into six diagnostic categories (Table 1).
The COPD group included 58 patients who had obstructive lung diseases and hypercapnic respiratory failure due to the following: emphysema and/or chronic bronchitis (51 patients); severe bronchiectasis (4 patients); or cystic fibrosis (3
Discussion
The present study illustrates the changes that have occurred in home NPPV in the Geneva Lake area since the publication of the studies by Leger et al20 and Simonds and Elliott.19 Bilevel pressure-cycled ventilation has become the default mode of ventilation in most indications (Fig 3), with results similar to volume-cycled ventilation in terms of the correction of daytime hypercapnia, survival, probability of pursuing NPPV (Fig 4), and a major reduction in cost (prices of volume-cycled
Conclusion
Noninvasive ventilation has emerged over the past 15 years as a valuable therapeutic option for the long-term treatment of chronic alveolar hypoventilation in patients with restrictive pulmonary disorders and, to a lesser degree in COPD patients, with an acceptable QOL.355556 Compliance with NPPV therapy in these patients is remarkably high when compared to that with other modes of respiratory assistance such as LTOT or nasal CPAP.57585960 Tolerance to treatment is also quite good.61 The
ACKNOWLEDGMENT
We express our gratitude to Dr. Daniela Stefanutti, MD, from the Children's Hospital of Geneva University Hospital, for her contribution to this study.
References (61)
- et al.
Intermittent positive pressure ventilation via nasal access in the management of respiratory insufficiency
Chest
(1987) - et al.
Ventilator management in Duchenne muscular dystrophy and postpoliomyelitis syndrome; twelve years' experience
Arch Phys Med Rehabil
(1989) - et al.
Prescription of nCPAP and nBiPAP in obstructive sleep apnoea syndrome: Italian experience in 105 subjects; a prospective two center study
Respir Med
(1998) - et al.
Obstructive sleep apnea treated by independently adjusted inspiratory and expiratory positive airway pressures via nasal mask: physiological and clinical implications
Chest
(1990) - et al.
Nasal intermittent positive pressure ventilation: long-term follow-up in patients with severe chronic respiratory insufficiency
Chest
(1994) - et al.
Is continuous transcutaneous CO2(PtcCO2) monitoring reliable over an 8 h period?
Respir Med
(2001) - et al.
Quality of life of patients treated by home mechanical ventilation due to restrictive ventilatory disorders
Respir Med
(1994) - et al.
Epidemiology of depression in primary care
Gen Hosp Psychiatry
(1992) - et al.
The Nagoya conference on system design and patient-ventilator interactions during pressure support ventilation
Chest
(1990) - et al.
The obesity-hypoventilation syndrome revisited: a prospective study of 34 consecutive cases
Chest
(2001)
Effects of short-term NIPPV in the treatment of patients with severe obstructive sleep apnea and hypercapnia
Chest
Failure of CPAP therapy in obstructive sleep apnoea syndrome: predictive factors and treatment with bi-level positive airway pressure
Respir Med
Noninvasive positive pressure ventilation and not oxygen may prevent overt ventilatory failure in patients with chest wall diseases
Chest
Long-term controlled trial of nocturnal nasal positive pressure ventilation in patients with severe COPD
Chest
Noninvasive ventilation
Am J Respir Crit Care Med
Relentless fight against an incurable disease: Duchenne's muscular dystrophy
Agressologie
Early nasal ventilatory support in Duchenne's muscular dystrophy
Agressologie
Nocturnal positive pressure ventilation via nasal mask
Am Rev Respir Dis
Treatment of respiratory failure during sleep in patients with neuromuscular disease: positive pressure through a nose mask
Am Rev Respir Dis
Management alternatives for post-polio respiratory insufficiency: assisted ventilation by nasal or oral-nasal interface
Am J Phys Med Rehabil
Home positive pressure ventilation via nasal mask for patients with neuromuscular weakness or restrictive lung or chest-wall disease
Respir Care
1998 yearly statistics
Observatoire
Die intermittierende mechanische ventilation als heimbehandlung
Ther Umsch
National statistics on domiciliary home mechanical ventilation
Comparison of two different modes for noninvasive mechanical ventilation in chronic respiratory failure: volume vs pressure controlled device
Eur Respir J
Management of obesity and respiratory insufficiency: the value of bi-level pressure-cycled nasal ventilation
Rev Mal Respir
Noninvasive ventilation and obstructive lung diseases
Eur Respir J
An evaluation of the Respironics BiPAP bi-level CPAP device for delivery of assisted ventilation
Respir Care
Outcome of domiciliary nasal intermittent positive pressure ventilation in restrictive and obstructive disorders
Thorax
Long term nasal intermittent positive pressure ventilation (NIPPV) in sixteen consecutive patients with bronchiectasis: a retrospective study
Eur Respir J
Cited by (252)
Domiciliary noninvasive ventilation for chronic respiratory diseases
2022, Medical Journal Armed Forces IndiaProposals from a French expert panel for respiratory care in ALS patients
2022, Respiratory Medicine and ResearchManagement of Obesity Hypoventilation Syndrome
2021, Encyclopedia of Respiratory Medicine, Second Edition