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[Home non-invasive ventilation for chronic obstructive pulmonary disease]
S Toujani1, S Dabboussi2, H Snene1
1Service de pneumologie, faculté de médecine de Tunis, université Tunis el Manar, hôpital la Rabta, UR12SP096 Tunis, Tunisie.
Introduction:
The benefits of long-term non-invasive ventilation (NIV) in the management of chronic obstructive pulmonary disease (COPD) patients remain controversial.
Aim:
To analyze the characteristics of COPD patients under home NIV and to evaluate its impact among this population.
Methods:
We carried out a retrospective study between January 2002 and April 2016 of COPD patients under long-term NIV at "la Rabta" and the Military Hospital.
Results:
There were 27 patients with an average age of 64 and a sex ratio (M/F) of 0.92. Active smoking was reported in 96.3%. A persistent hypercapnia following an acute exacerbation of COPD with failure to wean the NIV was the main indication of long-term NIV. We noted a reduction in hospital admissions in the first year of 60% and in intensive care of 83.3% (P<10-3). There was no non-significant decrease of PaCO2 (4.5mmHg). There was no modification in FEV 1 and in FVC (P>0.05). The survival rate was 96.3% at 1 year, 83.3% at 2 years and a median survival of 24 months.
Conclusions:
Our study suggests that home NIV contributes to the stabilization of some COPD patients by reducing the hospitalizations rates for exacerbation. More prospective studies are needed to better assess the impact of NIV on survival and quality of life and to better define the COPD patients who require NIV.
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