The prevalence of non-invasive ventilation and long-term oxygen treatment in Helsinki University Hospital area, Finland

Kotanen, Petra; Brander, Pirkko; Kreivi, Hanna-Riikka

doi:10.1186/s12890-022-02044-5

Cited by 6 publications

(2 citation statements)

References 31 publications

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“…Previous data have shown that home invasive mechanical ventilation is uncommon in Finland and becoming even more so [34]. In contrast, NIV and/or long-term oxygen are common treatments for chronic respiratory failure in Finland [35].…”

Section: Discussionmentioning

confidence: 99%

Amyotrophic Lateral Sclerosis in Southwestern and Eastern Finland

Hanhisuanto¹,

Solje²,

Jokela³

et al. 2023

Neuroepidemiology

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Introduction: The incidence of Amyotrophic lateral sclerosis (ALS) worldwide is approximately 1-2.6/1,000,000 and prevalence 5-6/100,000. ALS has been suggested to be relatively common in Finland but epidemiological information on the subject is scarce and outdated. Material and methods: Patients with ALS diagnostic codes were identified from mandatory administrative registries in the provinces of Southwestern Finland (population circa 430,000) and North Karelia (population circa 170,000) together comprising 11.7 % of the total population of Finland. The diagnoses were verified, and data extracted by reviewing the patient records. Incidence period was 2010-2018, and the prevalence date December 31, 2018. Age-standardization was performed using European Standard Population 2013 (ESP2013) Results: Overall crude incidence of ALS was 4.2/100'000 person-years in Southwestern Finland (ESP2013: 4.0/100,000) and 5.6/100,000 person-years in North Karelia (ESP2013: 4.8/100,000), while crude prevalences were 11,9/100,000 (ESP2013: 10.5/100,000) and 10,9/100'000 (ESP2013: 9.3/100,000), respectively. Mean age at diagnosis was 65.5-71.6 years in women (higher in Southwestern Finland compared to North Karelia, p=0.003) and 64.7-67.3 years in men (no difference between provinces, p=0.39). The diagnosis had been made in 50 % before the age of 70 years in Southwestern Finland and before the age of 65 years in 51 % in North Karelia. Genetic testing had been conducted in 28 % of all patients with the most common findings being SOD1 and c9orf72. After the diagnosis, mean survival was 2.0-2.7 and median survival 1.3-1.4 years. Onset phenotype (p<0.001), age at diagnosis (p<0.001) and genotype (p=0.001) predicted survival. Riluzole had been used by 25 % of patients and tracheostomy and invasive ventilation (TIV) had been performed in <1 %. Conclusions: Both incidence and prevalence of ALS in Finland are among the highest in the world but with some notable differences between the eastern and southwestern parts of the country. Low median life expectancy may be related to the advanced age of patients and the high prevalence of c9orf72 repeat expansion in Finland as well infrequent use of TIV and Riluzole.

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Section: Discussionmentioning

confidence: 99%

Amyotrophic Lateral Sclerosis in Southwestern and Eastern Finland

Hanhisuanto¹,

Solje²,

Jokela³

et al. 2023

Neuroepidemiology

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“…Persistent hypercapnic failure is defined as a partial pressure of carbon dioxide (PaCO 2 ) > 6 kPa, combined with elevated levels of standard bicarbonate (HCO 3 ) > 26.9 mmol/L (males)/26.2 mmol/L (females), and base excess (BE) > 3 mmol/L in an arterial blood gas analysis, carried out whilst the patient is in a stable phase [ 5 ]. As with persistent hypoxic failure, the literature is sparse on the prevalence of persistent hypercapnic failure, but in European cohorts of patients with very severe COPD, a prevalence of 22–25% is seen [ 6 , 7 ]. The prevalence of combined persistent hypoxic and hypercapnic respiratory failure is not described in the literature.…”

Section: Introductionmentioning

confidence: 99%

A Real-Life Study of Combined Treatment with Long-Term Non-Invasive Ventilation and High Flow Nasal Cannula in Patients with End-Stage Chronic Obstructive Lung Disease

Weinreich,

Storgaard

2023

JCM

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Patients with end-stage chronic obstructive pulmonary disease (COPD) often develop persistent hypoxic or hypercapnic respiratory failure, or a combination of both. Ventilatory support, in terms of a long-term high-flow nasal cannula (LT-HFNC) and long-term non-invasive ventilation (LT-NIV), may be indicated. Often, clinicians choose either one or the other. This paper explores combined treatment with LT-HFNC and LT-NIV in a real-life setting. In total, 33 patients with COPD and persistent respiratory failure were included in this study. Of those, 17 were initiated on LT-HFNC and used it for 595 (374) days and 16 were initiated on LT-NIV and used it for 558 (479) days. On average, patients used respiratory support continuously for 908 (586) days. Baseline characteristics were comparable, apart from PaCO2 at first ventilatory support initiation (LT-HFNC/LT-NIV 7.1 (1.1) kPa/8.8 (0.9) kPa respectively (p = 0.002)). Both groups experienced a reduction in hospitalizations in the first twelve months after treatment initiation, compared to the twelve months before (LT-HFNC p = 0.022 and LT-NIV p = 0.014). In total, 25% of LT-NIV patients stopped treatment after HFNC initiation due to intolerance and 59% stopped LT-HFNC treatment 126 (36) days after LT-NIV initiation as monotherapy was sufficient. In 44% of these patients, LT-HFNC was re-initiated at the end of life. At the time of analysis, 70% of patients had died. In the last three months of life, patients stopped using LT-NIV, whereas 91% used LT-HFNC. In conclusion, the combined use of LT-NIV and LT-HFNC reduced hospitalizations in patients with COPD and persistent respiratory failure. The study indicates that LT-HFNC is well tolerated, and better tolerated than LT-NIV at the very end stages of COPD.

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