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

Background: Home mechanical ventilation (HMV) is an important therapy for p atients with respiratory insufficiency on the basis of neuromuscular diseas es (NMD), chest wall deformities (CWD) and chronic obstructive pulmonary di sease (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 n on-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 t o 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 C OPD in comparison to CWD and NMD.