Domiciliary Non-invasive Ventilation in COPD: An International Survey of Indications and Practices
Domiciliary Non-invasive Ventilation in COPD: An International Survey of Indications and Practices
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DOI：
10.3109/15412555.2015.1108960
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发表时间：
2016-01-01
影响因子：
2.2
通讯作者：
Nava, Stefano
中科院分区：
文献类型：
--
作者：
Crimi, Claudia;Noto, Alberto;Nava, Stefano
尽管荟萃分析和临床指南不建议对诊断为严重稳定型慢性阻塞性肺病（COPD）和慢性呼吸衰竭的患者常规使用家庭无创通气（NIV），这是一些国家的普遍做法。我们对参与提供长期护理的医生进行了一项国际网络调查，长期NIV检查诊断为COPD患者的NIV使用模式，应答率为41.6%。住院率降低、生活质量改善和呼吸困难缓解被认为是患者的主要预期获益。夜间血氧饱和度评估是NIV处方前进行的主要程序。需要NIV的复发性急性加重（>3）和在医院NIV撤机失败是开始辅助NIV的最重要原因。压力支持通气（PSV）是最常见的模式，低强度设置（PSV-低）最受欢迎（44.4 30.1%），而高强度（PSV-高）策略（26.9 +/- 25.9%），地理偏好不同。COPD被证实是家庭NIV的常见适应症。反复发作和院内NIV撤机失败是其处方的主要原因。
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.