[Home mechanical ventilation: What's new?]

Home mechanical ventilation (HMV) has evolved significantly over the past decade. While initially used primarily for neuromuscular diseases, the increasing application of non-invasive ventilation (NIV) for chronic obstructive pulmonary disease (COPD) has demonstrated significant benefits in reducing mortality and hospitalizations. Concurrently, the prevalence of obesity hypoventilation syndrome (OHS) is rising, necessitating adapted treatment strategies. The newly updated German S3-guideline differentiates between NIV and invasive ventilation and includes refined indication criteria, particularly for COPD. Furthermore, it incorporates ethical considerations regarding decision-making in ventilation therapy and end of life. Alternative treatment options for chronic respiratory insufficiency are also gaining clinical and scientific attention. High flow therapy, which is already being used effectively for acute respiratory insufficiency, is increasingly being used for chronic respiratory insufficiency. Furthermore, the implementation of the Intensive Care and Rehabilitation Strengthening Act (IPREG) has established new quality standards in long-term mechanical ventilation, yet challenges persist in its nationwide application.