CHEST 2023 On Demand Pass-Initiating Long-Term Home Noninvasive Ventilation in the ICU

Video Transcription

Video Summary

The panel discussion focused on the use of long-term non-invasive ventilation in various patient populations. The key takeaway points were:<br /><br />In patients with hypercapnic COPD, the Cochrane Library review found that home bi-level positive airway pressure (BPAP) or home mechanical ventilation had a lower risk of mortality and all-cause hospital admissions when compared to controls.<br /><br />In patients with obesity hypoventilation syndrome (OHS) , CPAP has been shown to be effective in improving quality of life. However, there is limited evidence comparing CPAP to non-invasive ventilation in this patient population.<br /><br />Post-extubation, high-risk patients may benefit from preemptive non-invasive ventilation to reduce the risk of reintubation. Waiting for rescue non-invasive ventilation has been associated with worse outcomes.<br /><br />There was some discussion on the use of volume-targeted pressure support modes, with some evidence showing potential benefits in stabilizing ventilation in patients with ALS and other neuromuscular diseases.<br /><br />There was debate on the timing of initiating long-term non-invasive ventilation in hospitalized patients. The European Respiratory Society recommended waiting until after resolution of acute respiratory failure, whereas the American Thoracic Society suggested reassessing patients 2-4 weeks after resolution.<br /><br />Lastly, the panel emphasized the need for more randomized controlled trials to better evaluate the effectiveness of different non-invasive ventilation modes in various patient populations. Overall, the panel discussion provided insights into the current evidence, challenges, and ongoing research related to long-term non-invasive ventilation.

Meta Tag

Category Critical Care

Session ID 1161

Speaker Peter Gay

Speaker Atul Malhotra

Speaker Jovica Veljanovski

Speaker Lisa Wolfe

Track Critical Care

Track Sleep Disorders

Keywords

long-term non-invasive ventilation

hypercapnic COPD

home bi-level positive airway pressure

mortality

obesity hypoventilation syndrome

CPAP

non-invasive ventilation

reintubation

randomized controlled trials