Approach of pulmonologists in Turkey to noninvasive mechanical ventilation use at home for chronic respiratory failure.
BACKGROUND
To define approach of pulmonologists in Turkey to noninvasive mechanical ventilation (NIV) use for chronic respiratory failure (CRF), the most currently applied technique for home mechanical ventilation.


METHODS
A 38-question survey, developed and tested by the authors, was distributed throughout Turkey to 2205 pulmonologists by e-mail.


RESULTS
Twenty-seven percent of the pulmonologists responded (n=596). Domiciliary NIV was reported to be prescribed by 340 physicians [57.1% of all responders and 81% of pulmonologists practicing NIV at clinical practice (n= 420)]. NIV prescription was associated with physician's title, type of hospital, duration of medical license, total number of patients treated with NIV during residency and current number of patients treated with NIV per week (p< 0.05). Main estimated indications were listed as chronic obstructive pulmonary disease (median, 25-75 percentile of the prescriptions: 75%, 60-85), obesity hypoventilation syndrome (10%, 2-15), overlap syndrome (10%, 0-20) and restrictive lung disease (5%, 2-10). For utilization of NIV at home, Bilevel positive airway pressure-spontaneous mode (40%, 0-80) and oronasal mask (90%, 60-100) were stated as the most frequently recommended mode and interface, respectively. Pressure settings were most often titrated based on arterial blood gas findings (79.2%). Humidifier was stated not to be prescribed by approximately half of the physicians recommending domicilliary NIV, and the main reason for this (59.2%) was being un-refundable by social security foundation.


CONCLUSIONS
There is a wide variation in Turkey for prescription of NIV, which is supposed to improve clinical course of patients with CRF. Further studies are required to determine the possible causes of these differences, frequency of use and patient outcomes in this setting.
Clinic of Chest Diseases, Baskent University Istanbul Hospital, Istanbul, Turkey. aozsancak@hotmail.com.
Aylin
A
Özsancak Uğurlu
Huriye
H
Berk Takır
Begüm
B
Ergan
Erdal
E
İn
Ezgi
E
Özyilmaz
Özlem
Ö
Ertan Edipoğlu
Eylem
E
Acartürk
Ege
E
Güleç Balbay
Aslı
A
Görek Dilektaşlı
Tülay
T
Kıvanç
Pervin
P
Korkmaz Ekren
Sevinç
S
Sarınç Ulaşlı
Ilgaz
I
Doğrul
Elif
E
Yılmazel Uçar
Şehnaz
Ş
Olgun
Özkan
Ö
Devran
Recai
R
Ergun
Zuhal
Z
Karakurt
D000328:Adult; D002908:Chronic Disease; D002983:Clinical Competence; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D063087:Noninvasive Ventilation / Q000706:statistics & numerical data*; D000072106:Pulmonologists; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000628:therapy*; D011795:Surveys and Questionnaires; D014421:Turkey / Q000453:epidemiology