The prevalence of non-invasive ventilation and long-term oxygen treatment in Helsinki University Hospital area, Finland.

Chronic respiratory failure (CRF) can be treated at home with non-invasive ventilation (NIV) and/or long-term oxygen (LTOT). The prevalence of these treatments is largely unknown. We aimed to clarify the prevalence and indications of the treatments, and the three-year mortality of the treated patients in the Helsinki University Hospital (HUH) area in Finland. In this retrospective study we analyzed the prevalence of adult CRF patients treated with NIV and/or LTOT on 1.1.2018 and followed these patients until 1.1.2021. Data collected included the underlying diagnosis, patient characteristics, information on treatment initiation and from the last follow-up visit, and mortality during the three-year follow-up. Patients with home invasive mechanical ventilation or sleep apnea were excluded. On 1.1.2018, we had a total of 815 patients treated with NIV and/or LTOT in the Helsinki University Hospital (HUH) area, with a population of 1.4 million. The prevalence of NIV was 35.4 per 100,000, of LTOT 24.6 per 100,000 and of the treatments combined 60.0 per 100,000. Almost half, 44.5%, were treated with NIV, 41.0% with LTOT, and 14.4% underwent both. The most common diagnostic groups were chronic obstructive pulmonary disease (COPD) (33.3%) and obesity-hypoventilation syndrome (OHS) (26.6%). The three-year mortality in all patients was 45.2%. In the COPD and OHS groups the mortality was 61.3% and 21.2%. In NIV treated patients, the treatment durations varied from COPD patients 5.3 years to restrictive chest wall disease patients 11.4 years. The age-adjusted Charlson co-morbidity index (ACCI) median for all patients was 3.0. NIV and LTOT are common treatments in CRF. The prevalence in HUH area was comparable to other western countries. As the ACCI index shows, the treated patients were fragile, with multiple co-morbidities, and their mortality was high. Treatment duration and survival vary greatly depending on the underlying diagnosis.

Kotanen P ，Brander P ，Kreivi HR 《BMC Pulmonary Medicine》

Home-Based Care Evolution in Chronic Respiratory Failure between 2001 and 2015 (Antadir Federation Observatory).

The aetiologies of chronic respiratory failure (CRF) are moving in many western countries. Obesity-Hypoventilation syndrome (OHS) has become one of the most common indications of non-invasive ventilation (NIV) with Chronic Obstructive Pulmonary Diseases (COPD). Long-Term Oxygen Therapy (LTOT) technology is the treatment plan for CRF patients in the new era. This study aimed to assess home-based care evolution in CRF patients on LTOT (LTOT) and/or NIV from the ANTADIR observatory. A computerized database from 14 regional facilities was analysed (30% of French home-treated patients). Patient age, sex, aetiology, home respiratory devices were recorded between 2001 and 2015. By the end of 2015, 12,147 CRF patients received LTOT (40%), NIV (24%), LTOT + NIV (23%), continuous positive airway pressure (CPAP; 11%) or LTOT + CPAP (3%). Between 2001 and 2015, we observed a decrease of LTOT (63-40%) in the benefit of NVI ± LTOT (25-47%). Regarding the aetiology, we note a slight decrease in obstructive disease and a significant increase in restrictive disease, mainly due to OHS. The 10-year survival was better on NIV ± LTOT than on LTOT, for overall patients and for both obstructive and restrictive patients. The 10-year survival was better on NIV ± LTOT than on LTOT (35 vs. 10%, p < 0.05). In COPD patients on LTOT, a switch from conventional to new home devices was observed. Stationary LTOT systems were less prescribed, while portable/transportable -system, liquid oxygen and self-filling oxygen were increasingly prescribed. Our study confirmed changes in CRF aetiologies and home devices. OHS is now an important indication of NIV. Using new LTOT technologies changed home prescriptions in COPD patients.

Melloni B ，Mounier L ，Laaban JP ，Chambellan A ，Foret D ，Muir JF ... -  《-》

Noninvasive ventilation for severely acidotic patients in respiratory intermediate care units : Precision medicine in intermediate care units.

Masa JF ，Utrabo I ，Gomez de Terreros J ，Aburto M ，Esteban C ，Prats E ，Núñez B ，Ortega-González Á ，Jara-Palomares L ，Martin-Vicente MJ ，Farrero E ，Binimelis A ，Sala E ，Serrano-Rebollo JC ，Barrot E ，Sánchez-Oro-Gomez R ，Fernández-Álvarez R ，Rodríguez-Jerez F ，Sayas J ，Benavides P ，Català R ，Rivas FJ ，Egea CJ ，Antón A ，Peñacoba P ，Santiago-Recuerda A ，Gómez-Mendieta MA ，Méndez L ，Cebrian JJ ，Piña JA ，Zamora E ，Segrelles G ... -  《BMC Pulmonary Medicine》

A decade of domiciliary non-invasive ventilation in the west of Ireland.

Gouda P ，Chua J ，Langan D ，Hannon T ，Scott A ，O'Regan A ... -  《-》

Trends in Prevalence and Prognosis in Subjects With Acute Chronic Respiratory Failure Treated With Noninvasive and/or Invasive Ventilation.

The pattern and outcome of noninvasive ventilation (NIV) use in patients with acute or chronic respiratory disease other than COPD is not well known. The aims of this study were to investigate trends over time in underlying respiratory diseases, use of NIV, and outcomes in COPD and non-COPD patients with acute respiratory failure. We made a retrospective analysis of data recorded prospectively from 1,113 subjects admitted between 1998 and 2012. Subject diagnoses were distributed as follows: COPD, n=568 (51%); bilateral bronchiectasis, n=113 (10%); obesity, n=166 (15%); chronic diffuse interstitial lung disease, n=131 (12%); restrictive pulmonary disease, n=113 (10%); and asthma, n=22 (2%). The proportion of subjects with bilateral bronchiectasis significantly decreased (OR 0.91, 95% CI 0.865-0.951, P<.001), whereas the proportion of subjects with obesity increased (OR 1.03, 95% CI 1.001-1.063, P=.049) over time. The use of NIV (OR 1.05, 95% CI 1.010-1.090, P=.01) and the proportion of subjects initially treated with NIV (OR 1.05, 95% CI 1.013-1.094, P=.009) increased significantly in COPD subjects only. Time trend of mortality was not significant (OR 0.98, 95% CI 0.95-1.01, P=.23), whereas the severity of illness in subjects significantly increased. Transition from NIV to invasive mechanical ventilation (IMV) (OR 2.05, 95% CI 1.36-3.11, P=<.001), IMV (OR 10.49, 95% CI 4.88-10.56, P<.001) and diffuse interstitial lung disease (OR 10.63, 95% CI 5.43-20.83, P<.001) were independently associated with death in the ICU. Over time, respiratory diseases have changed in non-COPD subjects and trends in the use and efficacy of NIV differ between COPD and non-COPD subjects. Mortality remained stable while the severity of illness in subjects increased. In COPD and non-COPD subjects, transition from NIV to IMV was associated with a poorer prognosis.

Gacouin A ，Jouneau S ，Letheulle J ，Kerjouan M ，Bouju P ，Fillatre P ，Le Tulzo Y ，Tadié JM ... -  《-》