Infrastructure, funding and follow-up in a programme of noninvasive ventilation

Originating from centres charged with the care of patients with chronic respiratory insufficiency, noninvasive ventilation (NIV) has been used increasingly in chronic and acute respiratory failure during the last decade. Despite a considerable number of series and randomised studies advocating access to NIV for units that treat acute or chronic ventilatory failure, the number of units and the proportion of total ventilatory support remains poor. This is due to lack of education, as many units treat only a few patients per year. Indication, technique, education, monitoring and home care require special experience and a special environment and there is a wide range throughout Europe. With respect to home care in particular, there are many organisations, which range from totally private to hospital based or run for profit. A concerted action, funded by the European Union, will soon provide valuable information about the practice of home ventilation in Europe based on a European survey.