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[Non-invasive home ventilation (NIHV): long-term survival of 32 cases]
J P Janssens1, P Kehrer, J C Chevrolet
1Division de Pneumologie, Hôpitaux Universitaires de Genève, Suisse.
Aim Of The Study:
To analyze the course of respiratory function, compliance and tolerance to treatment, and quality of life in patients treated by NIHV, and the impact of NIHV on hospitalizations.
Methods:
Prospective study of 32 patients who underwent annual evaluation of FEV1, FVC, PImax, PEmax, arterial blood gases (ABG), nocturnal pulse oxymetry, 6-minute walk test (6'W), tolerance to treatment and quality of life (scores for dyspnea, physical independence, emotional disturbances).
Patients:
32 patients (median age 59 y, range 20-79) including 44% who were professionally active, suffering from predominantly restrictive (n = 30) or obstructive (n = 2) syndromes, under volumetric (n = 25) or barometric (BiPAP, n = 7) NIHV, were followed for 43 months (median; range 5-54 months).
Results:
Throughout the study period, FEV1, FVC, PImax, PEmax, and 6'W remained stable and initial benefit on ABG was maintained. Compliance rate to NIPPV was 85%, 3-year survival was 90%. A major decrease in hospitalizations after initiation of NIHV, low resting dyspnea and a low prevalence of depression and anxiety contributed to a satisfactory quality of life.
Conclusions:
Home NIPPV stabilizes pulmonary function tests, has a durable positive effect on PaCO2; the marked decrease in hospitalization rates after initiation of NIPPV contributes to improved quality of life while controlling medical costs.