LONG-TERM EFFICIENCY OF HOME NASAL MASK VENTILATION IN PATIENTS WITH DIFFUSE BRONCHIECTASIS AND SEVERE CHRONIC RESPIRATORY-FAILURE - A CASE-CONTROL STUDY

The aim of this study was to evaluate long-term efficacy and tolerance of nasal mask ventilation (NMV) in a comparative case-control study, Fourteen patients with diffuse bronchiectasis and severe chronic respi ratory failure (CRF), treated by long-term oxygen-therapy (LTO) and NM V, were case matched with 14 patients with diffuse bronchiectasis and severe CRF treated with only LTO, Patients and control subjects were c ompared based on the following parameters: blood gases, FEV1, vital ca pacity, hospitalizations, and survival, Symptoms, Karnofsky function s core, and clinical evolution were also monitored in patients, Three su bgroups may be identified according to outcome: two early deaths (subg roup I), six: patients with initial improvement and subsequent deterio ration (subgroup 2), and six patients whose conditions remained improv ed for >2 years (subgroup 3), PaO2 decrease slope was slighter in this last subgroup than subgroup 2, The days of hospitalization were signi ficantly reduced after institution of NMV in the patient group, Compar ison between patients and control subjects did not show any difference on PaO2 evolution and on the overall median survival (46 and 40 month s in NMV and control group, respectively), Long-term tolerance and com pliance remained satisfactory for 11 patients, These results suggest t hat NMV is feasible as a long-term home treatment in patients with dif fuse bronchiectasis. Although our results may have failed to prove a l ong-term efficiency on the course of blood gases and survival, a benef icial effect is observed with reduction of hospitalizations and improv ement of functional status, This study warrants further investigation, in a prospective series, with a larger number of patients.