Is it still relevant to consider polysomnography as essential for noninvasive ventilation titration?

Borel, Jean‐Christian; Gonzalez-Bermejo, Jésus

doi:10.1183/13993003.00619-2019

Cited by 6 publications

(3 citation statements)

References 14 publications

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“…The American Association of Sleep Medicine (AASM) and several other groups recommend the systematic use of PSG (polysomnography) for titration of NIV in OHS [137]. This is however not realistic in most countries, because of the restricted availability of PSG and, sometimes, the lack of expertise of sleep centers in NIV titration [138]. The SIG does not consider PSG as mandatory for titration of NIV.…”

Section: Obesity-hypoventilation Syndromementioning

confidence: 99%

Long-Term Mechanical Ventilation: Recommendations of the Swiss Society of Pulmonology

et al. 2020

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Long-term mechanical ventilation is a well-established treatment for chronic hypercapnic respiratory failure (CHRF). It is aimed at improving CHRF-related symptoms, health-related quality of life, survival, and decreasing hospital admissions. In Switzerland, long-term mechanical ventilation has been increasingly used since the 1980s in hospital and home care settings. Over the years, its application has considerably expanded with accumulating evidence of beneficial effects in a broad range of conditions associated with CHRF. Most frequent indications for long-term mechanical ventilation are chronic obstructive pulmonary disease, obesity hypoventilation syndrome, neuromuscular and chest wall diseases. In the current consensus document, the Special Interest Group of the Swiss Society of Pulmonology reviews the most recent scientific literature on long-term mechanical ventilation and provides recommendations adapted to the particular setting of the Swiss healthcare system with a focus on the practice of non-invasive and invasive home ventilation in adults.

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Section: Obesity-hypoventilation Syndromementioning

confidence: 99%

Long-Term Mechanical Ventilation: Recommendations of the Swiss Society of Pulmonology

et al. 2020

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“…Tras la adaptación diurna, la titulación en un laboratorio de sueño representa la mejor opción para establecer los settings de los ventiladores 69,70 . De todo ello se deduce que la complejidad clínica de los pacientes y la complejidad tecnológica de los equipos de VMNI actuales hacen imprescindible que expertos con experiencia adecúen los parámetros ventilatorios, hecho que no siempre se alcanza durante la primera noche de titulación.…”

Section: Ventilación Mecánicaunclassified

Posicionamiento de la Sociedad Española de Neumología y Cirugía Torácica en el uso de la telemedicina en los trastornos respiratorios del sueño y ventilación mecánica

Canal

Suárez-Girón

Egea

et al. 2021

Archivos de Bronconeumología

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Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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“…Optimal modalities for monitoring of long-term ventilated patients remain a matter of debate. As previously mentioned, complete polysomnography (PSG) under NIV is performed by some groups, but is not feasible in most centers on a routine basis ( 74 ).…”

Section: Introductionmentioning

confidence: 99%

Monitoring Long Term Noninvasive Ventilation: Benefits, Caveats and Perspectives

Janssens

Cantero

Pasquina³

et al. 2022

Front. Med.

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Long term noninvasive ventilation (LTNIV) is a recognized treatment for chronic hypercapnic respiratory failure (CHRF). COPD, obesity-hypoventilation syndrome, neuromuscular disorders, various restrictive disorders, and patients with sleep-disordered breathing are the major groups concerned. The purpose of this narrative review is to summarize current knowledge in the field of monitoring during home ventilation. LTNIV improves symptoms related to CHRF, diurnal and nocturnal blood gases, survival, and health-related quality of life. Initially, patients with LTNIV were most often followed through elective short in-hospital stays to ensure patient comfort, correction of daytime blood gases and nocturnal oxygenation, and control of nocturnal respiratory events. Because of the widespread use of LTNIV, elective in-hospital monitoring has become logistically problematic, time consuming, and costly. LTNIV devices presently have a built-in software which records compliance, leaks, tidal volume, minute ventilation, cycles triggered and cycled by the patient and provides detailed pressure and flow curves. Although the engineering behind this information is remarkable, the quality and reliability of certain signals may vary. Interpretation of the curves provided requires a certain level of training. Coupling ventilator software with nocturnal pulse oximetry or transcutaneous capnography performed at the patient's home can however provide important information and allow adjustments of ventilator settings thus potentially avoiding hospital admissions. Strategies have been described to combine different tools for optimal detection of an inefficient ventilation. Recent devices also allow adapting certain parameters at a distance (pressure support, expiratory positive airway pressure, back-up respiratory rate), thus allowing progressive changes in these settings for increased patient comfort and tolerance, and reducing the requirement for in-hospital titration. Because we live in a connected world, analyzing large groups of patients through treatment of “big data” will probably improve our knowledge of clinical pathways of our patients, and factors associated with treatment success or failure, adherence and efficacy. This approach provides a useful add-on to randomized controlled studies and allows generating hypotheses for better management of HMV.

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Is it still relevant to consider polysomnography as essential for noninvasive ventilation titration?

Cited by 6 publications

References 14 publications

Long-Term Mechanical Ventilation: Recommendations of the Swiss Society of Pulmonology

Long-Term Mechanical Ventilation: Recommendations of the Swiss Society of Pulmonology

Posicionamiento de la Sociedad Española de Neumología y Cirugía Torácica en el uso de la telemedicina en los trastornos respiratorios del sueño y ventilación mecánica

Monitoring Long Term Noninvasive Ventilation: Benefits, Caveats and Perspectives

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