Acceptance and long-term results of home mechanical ventilation in various thoracic diseases

Background: Home mechanical ventilation (HMV) is an important therapy for patients with respiratory insufficiency on the basis of neuromuscular diseases (NMD), chest wall deformities (CWD) and chronic obstructive pulmonary disease (COPD). Patients and Methods: We retrospectively analyzed the long-term results of all 144 patients (CWD = 47, COPD = 54, NMD = 43) who underwent a trial of non-invasive HMV from March 1990 to September 1997. Results: Twentyeight patients did not accept the HMV (19%), 7 with CWD, (15%), 17 with COPD (32%) and 1 with NMD (9%). Thirtynine of 113 patients, who accepted HMV, completed nasal ventilation for a minimum of 1 year. For all 3 groups the hypercapnia improved significantly (CWD 58 +/- 6 to 48 +/- 4 mm Hg, p < 0,001, COPD 61 +/- 7 to 46 +/- 6 mmHg, p < 0,001, NMD 53 +/- 8 to 42 +/- 6 mm Hg, p < 0,001). Conclusion: HMV improves the hypercapnic ventilatory failure independent of the underlying disease. The rate of acceptance if lower in patients with COPD in comparison to CWD and NMD.