Daytime noninvasive ventilatory support for patients with ventilatory pump failure: a narrative review

Banfi, Paolo; Pierucci, Paola; Volpato, Eleonora; Nicolini, Antonello; Lax, Agata; Robert, Dominique; Bach, John R.

doi:10.1186/s40248-019-0202-7

Cited by 15 publications

(21 citation statements)

References 92 publications

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“…A mouthpiece is usually the first choice for diurnal ventilation to avoid facial-skin breakdowns and facilitate speaking, eating, swallowing, and coughing ( 32 , 75 ). Nevertheless, depending on the patient preference or ability to use a mouthpiece, nasal-mask ventilation can also be used around the clock ( 76 , 77 ). Following reports that diurnal mouthpiece ventilation was associated with longer survival than invasive ventilation ( 78 ), many experts now strongly advocate for the use of non-invasive ventilation when both nocturnal and diurnal ventilation are needed.…”

Section: Contraindications For Long-term Non-invasive Ventilationmentioning

confidence: 99%

Long-Term Non-invasive Ventilation in Children: Current Use, Indications, and Contraindications

Praud

2020

Front. Pediatr.

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This review focuses on the delivery of non-invasive ventilation-i.e., intermittent positive-pressure ventilation-in children lasting more than 3 months. Several recent reviews have brought to light a dramatic escalation in the use of long-term non-invasive ventilation in children over the last 30 years. This is due both to the growing number of children receiving care for complex and severe diseases necessitating respiratory support and to the availability of LT-NIV equipment that can be used at home. While significant gaps in availability persist for smaller children and especially infants, home LT-NIV for children with chronic respiratory insufficiency has improved their quality of life and decreased the overall cost of care. While long-term NIV is usually delivered during sleep, it can also be delivered 24 h a day in selected patients. Close collaboration between the hospital complex-care team, the home LT-NIV program, and family caregivers is of the utmost importance for successful home LT-NIV. Long-term NIV is indicated for respiratory disorders responsible for chronic alveolar hypoventilation, with the aim to increase life expectancy and maximize quality of life. LT-NIV is considered for conditions that affect respiratory-muscle performance (alterations in central respiratory drive or neuromuscular function) and/or impose an excessive respiratory load (airway obstruction, lung disease, or chest-wall anomalies). Relative contraindications for LT-NIV include the inability of the local medical infrastructure to support home LT-NIV and poor motivation or inability of the patient/caregivers to cooperate or understand recommendations. Anatomic abnormalities that interfere with interface fitting, inability to protect the lower airways due to excessive airway secretions and/or severely impaired swallowing, or failure of LT-NIV to support respiration can lead to considering invasive ventilation via tracheostomy. Of note, providing home LT-NIV during the COVID 19 pandemic has become more challenging. This is due both to the disruption of medical systems and the fear of contaminating care providers and family with aerosols generated by a patient positive for SARS-CoV-2 during NIV. Delay in initiating LT-NIV, decreased frequency of home visits by the home ventilation program, and decreased availability of polysomnography and oximetry/transcutaneous PCO 2 monitoring are observed. Teleconsultations and telemonitoring are being developed to mitigate these challenges.

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Section: Contraindications For Long-term Non-invasive Ventilationmentioning

confidence: 99%

Long-Term Non-invasive Ventilation in Children: Current Use, Indications, and Contraindications

Praud

2020

Front. Pediatr.

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“…mouthpiece ventilation) is necessary and warranted [10][11][12][13][14]. To the best of our knowledge, only a few studies in the literature have tried to assess settings and current NIV practices in RTD [7,[15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

REINVENT: ERS International survey on REstrictive thoracic diseases IN long term home noninvasive VENTilation

et al. 2021

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Background and aimLittle is known about the current use of long-term home non-invasive ventilation (LTHNIV) in restrictive thoracic diseases (RTD), including chest wall and neuromuscular disorders (CWD, NMD). This study aimed to capture the pattern of LTHNIV in RTD patients via a web-based international survey.MethodsThe survey involved ERS Assembly 2.02 (NIV dedicated group) October-December 2019.Results166/748 (22.2%) members from 41 countries responded; 80% were physicians, of whom 43% worked in a respiratory intermediate intensive care unit (RIICU). The NMD:CWD ratio was 5:1, Amyotrophic lateral sclerosis (ALS) being the most frequent indication within NMD (78%). The main reason to initiate LTHNIV was diurnal hypercapnia (71%). Quality of life/sleep was the most important goal to achieve. In 25% of cases, clinicians based their choice of the ventilator on patients’ feedback. Among NIV-modes, pressure support ventilation spontaneous-timed (PSV-ST) was the most frequently prescribed for day and night-time. Mouthpieces were the preferred daytime NIV interface, whereas oro-nasal masks the first choice overnight. Heated humidification was frequently added to LTHNIV (72%). Single-limb circuits with intentional leaks (79%) were the most frequently prescribed. Follow-up was most often provided in an outpatient setting.ConclusionsThis ERS survey illustrates physicians’ practices of LTHNIV in RTD patients. NMD and, specifically, ALS were the main indications for LTHNIV. NIV was started mostly because of diurnal hypoventilation with a primary goal of patient-centred benefits. Bi-level PSV-ST and oro-nasal masks were more likely to be chosen for providing NIV. LTHNIV efficacy was assessed mainly in an outpatient setting.

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“…The sack compresses the abdomen to raise the diaphragm and to increase tidal volumes. 4 , 5 IAPV use by LOPD patients has not yet been described, and we aimed to report its feasibility in this study.…”

mentioning

confidence: 99%

“… 3 Varying interfaces helps avoid excessive skin pressure, mouth and upper airway dryness, mucus impaction, social interaction and eating difficulties. 3 , 5 , 7 Daytime IAPV facilitates activities of daily living to improve QoL, especially for patients unwilling to use daytime NVS. 4 …”

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Prioritizing care for severe asthma during SARS-CoV-2 pandemic

Benfante

Scichilone

2021

Pulmonology

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Daytime noninvasive ventilatory support for patients with ventilatory pump failure: a narrative review

Cited by 15 publications

References 92 publications

Long-Term Non-invasive Ventilation in Children: Current Use, Indications, and Contraindications

Long-Term Non-invasive Ventilation in Children: Current Use, Indications, and Contraindications

REINVENT: ERS International survey on REstrictive thoracic diseases IN long term home noninvasive VENTilation

Prioritizing care for severe asthma during SARS-CoV-2 pandemic

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