Home noninvasive ventilation (NIV) in France. Data from the Antadir-GAV cohort. Results at 18 months
EUROPEAN RESPIRATORY JOURNAL(2017)
摘要
The effectiveness of home NIV for chronic respiratory failure (CRF) is well established. However, little data is available about its epidemiology. The ANTADIR-GAV cohort is aimed to prospectively analyze data from patients initiated to home NIV in France. Methods: Multicentric prospective observational study. Etiology of CRF, demographic data, comorbidities, NIV setting, arterial blood gases, type/parameters of ventilator and interface were collected. Results: From 5/2015 to 12/2016, 964 patients (54% male, age 64±14 y, BMI 28±10 kg/m²) were included in 19 centers. CRF resulted from neuromuscular (51%), thoracic cage (24%) or parenchyma (25%) impairment. The most frequent etiologies were amyotrophic lateral sclerosis (36%), COPD (22%) and obesity hypoventilation (19%). Main comorbidities were hypertension (40%), diabetes (18%), arrhythmia (13%) and coronary heart disease (8%). Before NIV initiation PaO2 was 73±14 and PaCO2 49 ±8 mmHg. Most patients used single circuit pressure ventilators with calibrated leak (99%) and most used modes ST (83%), S (10%) and hybrid (4%). NIV was introduced in 892 patients using a bilevel ventilator without battery (47%) or with battery (45%). A life support ventilator was needed in 8% patients. IPAP, EPAP and backup respiratory rate were respectively 16±4 cmH2O, 7±3 cmH20 and 15±3 c/min. Preferred interface was an orofacial mask (80%). Additional oxygen was needed in 32% patients. NIV was introduced after acute respiratory failure in 43% patients and electively in 57% Conclusion: This cohort gives new insights about recent trends in home NIV practice in France. Recruiting is being pursued and adherence /survival data will be secondarily assessed.
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