PT - JOURNAL ARTICLE AU - Enrica Bertella AU - Sonia Gilè AU - Domenico Fiorenza AU - Mara Paneroni AU - Luca Bianchi AU - Paolo Banfi AU - Silvia Grilli AU - Michele Vitacca TI - Is outpatient initiation of non invasive ventilatory support not inferior to inpatient initiation in ALS patients? DP - 2014 Sep 01 TA - European Respiratory Journal PG - P4740 VI - 44 IP - Suppl 58 4099 - http://erj.ersjournals.com/content/44/Suppl_58/P4740.short 4100 - http://erj.ersjournals.com/content/44/Suppl_58/P4740.full SO - Eur Respir J2014 Sep 01; 44 AB - In ALS patients we evaluated if outpatient initiation (OP) to NIV is effective as inpatient initiation (IP) in terms of: adherence to NIV (≥ 150 hours/months), respiratory function changes, symptoms and patient's satisfaction.Patients were randomized into 2 groups (OP vs IP). Diurnal adaptation, advice to use nocturnal NIV until adaptation (≥ 6 hours/night for 3 nights) were conducted in a respiratory ward with H 24 care (IP) or as outpatient with at least 4 hours of care during scheduled visits (OP). Educational sessions were as much as needed to accept NIV and learn ventilator management. Arterial blood gas analysis (ABG), pulmonary function tests (PFT), sleep study and symptoms assessment (dyspnea, sleep quality) with visual analogue scale (VAS) were performed. At discharge, VAS for patient satisfaction (PS-VAS), difficulty to NIV initiation (DI-VAS) and ventilator management (DM-VAS) were performed. After 3 months basal exams and symptoms assessment were repeated.50 patients (25 for group) (19 female) aged 65±9.4 years participated to the study being similar in terms of ALS score, age, BMI, PFT and ABG. The number of patients non adherent to NIV was not different in IP (5) vs OP (6) group.After 3 months, the number of hours of nocturnal ventilation in adherent patients was higher in OP (7.8±1.06) than in IP (7.0±0.5) (p<0.05); IP reported higher DM-VAS than OP (3.2±2.6 vs 1.5±1.9, respectively, p= 0.05). Satisfaction, symptoms, PFT, sleep data and ABG variation were similar into the 2 groups.In ALS, OP initiation of NIV is not inferior to IP initiation. OP adherent patients used nocturnal NIV longer and presented less difficulties in NIV management.