title: Domiciliary Non-invasive Ventilation in COPD: An International Survey of Indications and Practices.
abstract: Despite the fact that metanalyses and clinical guidelines do not recommend the routine use of domiciliary non-invasive ventilation (NIV) for patients diagnosed with severe stable Chronic Obstructive Pulmonary Disease (COPD) and with chronic respiratory failure, it is common practice in some countries. We conducted an international web-survey of physicians involved in provision of long-term NIV to examine patterns of domiciliary NIV use in patients diagnosed with COPD. The response rate was 41.6%. A reduction of hospital admissions, improvements in quality of life and dyspnea relief were considered as the main expected benefits for patients. Nocturnal oxygen saturation assessment was the principal procedure performed before NIV prescription. Recurrent exacerbations (>3) requiring NIV and failed weaning from in hospital NIV were the most important reasons for starting domiciliary NIV. Pressure support ventilation (PSV) was the most common mode, with "low" intensity settings (PSV-low) the most popular (44.4 ± 30.1%) compared with "high" intensity (PSV-high) strategies (26.9 ± 25.9%), with different geographical preferences. COPD is confirmed to be a common indication for domiciliary NIV. Recurrent exacerbations and failed weaning from in-hospital NIV were the main reasons for its prescription.
authors.affiliation: a Respiratory Intensive Care Unit , Azienda Ospedaliera per l'Emergenza Cannizzaro , Catania , Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Crimi
authors.affiliation: b Department of Anesthesia and Critical Care , Policlinico G. Martino , Messina , Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Noto
authors.affiliation: c National Research Council , Messina , Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Princi
authors.affiliation: d Department of Pulmonary and Intensive Care , Rouen University Hospital , Rouen , France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Cuvelier
authors.affiliation: e Pulmonary Division, San Pedro de Alcantara Hospital, Caceres, Spain and CIBERES, National Research Network. ISCIII . Madrid , Spain.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Masa
authors.affiliation: f Royal Brompton and Harefield NHS Foundation Trust, National Institute of Health Research, Respiratory Biomedical Research Unit, London, United Kingdom and Imperial College London, Respiratory Medicine , London , United Kingdom.
authors.forename: Anita
authors.initials: A
authors.lastname: Simonds
authors.affiliation: g Department of Respiratory Medicine , St James's University Hospital , Leeds , United Kingdom.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Elliott
authors.affiliation: h Department of Pulmonary Diseases/Home Mechanical Ventilation , University Medical Center of Groningen , Groningen , Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Wijkstra
authors.affiliation: i Lung Clinic, Cologne Merheim Hospital , Faculty of Health/School of Medicine , Cologne , Germany.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Windisch
authors.affiliation: j Alma Mater University, Department of Clinical, Integrated and Experimental Medicine (DIMES) , Respiratory and Critical Care Unit , S. Orsola-Malpighi Hospital, Bologna , Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Nava
mesh_terms: D018450:Disease Progression; D004417:Dyspnea / Q000209:etiology / Q000628:therapy*; D005060:Europe; D006699:Home Care Services; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D063087:Noninvasive Ventilation / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000628:therapy*; D000072106:Pulmonologists; D011788:Quality of Life; D011795:Surveys and Questionnaires; D015300:Ventilator Weaning
keywords: chronic respiratory failure; home mechanical ventilation; hypercapnia; questionnaire; survey