Technological advances in home non‐invasive ventilation monitoring: Reliability of data and effect on patient outcomes

Abstract

Home non‐invasive mechanical ventilation (NIV) has become a well‐established treatment for patients with chronic hypercapnic respiratory failure. NIV monitoring has been developed to evaluate the effectiveness of mechanical ventilation on patient outcomes, with built‐in systems providing data on compliance, leaks and respiratory parameters. Although these data seem intuitively useful, two main concerns have been raised in the literature: (i) are they reliable and (ii) to what extent does their use improve patient outcomes. These two concerns are currently relevant since the very recent development of telemonitoring provides the possibility of adjusting ventilator settings remotely, based on the longitudinal assessment of NIV parameters and respiratory variables provided by the system. This may influence the future management strategies of health organizations for patients under home NIV. This narrative review describes technological advances in patient monitoring using home mechanical ventilation with a main focus on data provided by built‐in NIV monitoring systems. The use of these systems is discussed, including their advantages and limitations in different clinical situations, and perspectives for long‐term patient monitoring are discussed.

ERS International Congress 2019: highlights from Best Abstract awardees

“…This strategy is attractive as it requires only minimal additional measurements and data can be post-processed to derive an asynchrony index. However, further studies must prove whether this strategy identifies all relevant PVAs adequately and whether these PVAs are associated with important patient outcomes [21]. Overall, to improve care, monitoring chronic ventilatory assistance should be practical and lead to worthwhile benefits.…”

Contemporary Concise Review 2019: Sleep and ventilation

“…Whether NIV offers additional benefits over CPAP in this group is currently unknown but we favour use of NIV in hypercapnic COPD both in the acute and longer term setting. How best to initiate and titrate NIV, including use and incorporation of technological advances in monitoring systems are areas in need of research For patients with cystic fibrosis (CF), 2019 was a landmark year given major advances in pharmacotherapy for these patients .…”

Diagnostic accuracy of simple tools in monitoring patients with chronic hypoventilation treated with non-invasive ventilation; a prospective cross-sectional study

“…Further details on this is beyond the scope of this thesis, but can be found in a recent review. 267 The review states that further studies evaluating automated analyses of AHI by NIV devises are needed.…”