Extract
Setting the parameters of long-term nocturnal noninvasive ventilation (NIV) is crucial for effective correction of alveolar hypoventilation and respiratory events during sleep. Moreover, the treatment must be comfortable to ensure patient compliance from the beginning. Adaptation to NIV is usually carried out during daytime. The problem is that daytime behaviours may not reflect sleep ventilatory patterns and since respiratory events persist during sleep, mismatches between the patient and the ventilator may result [1]. It is widely believed that asynchrony events reduce the quality of ventilation and sleep, thus clinicians frequently attempt to identify the different types of asynchrony, their causes and how to limit their effects [2]. Titration of NIV by attended polysomnography (PSG) is considered to be the gold standard for the observation and correction of such events. However, PSG is complex, it may be difficult to access and the benefits of carrying out systematic PSG as part of a routine assessment remains in debate [3].
Abstract
Titration of noninvasive ventilation by polysomnography reduces patient–ventilator asynchrony and may be useful to improve treatment tolerance in patients who are struggling with NIV http://bit.ly/2v1RDty
Footnotes
Conflict of interest: J-C. Borel is employed by AGIR à dom, a non-profit home care provider, has received grants and personal fees from Philips and Resmed, and is co-inventor of a patent with Nomics SA.
Conflict of interest: J. Gonzalez-Bermejo reports personal fees for consultancy and educational activities from Resmed, Philips, Breas and Lowenstein, during the conduct of the study; personal fees for consultancy and educational activities from Synapse Biomedical, outside the submitted work.
- Received March 27, 2019.
- Accepted April 3, 2019.
- Copyright ©ERS 2019