Résumé :
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Although HMV is useful for the management of chronic respiratory failure complicating neuromuscular disease (NMD) and chest wall disease (CWD), the Eurovent survey (Lloyd-Owen et al, 2005) demonstrated differences in underlying diagnosis of HMV patients with increased use in COPD patients in Southern EU countries, despite limited evidence. However, the survey did not focus on obesity-related respiratory failure (ORRF) in patients with obstructive sleep apnoea (OSA) and obesity hypoventilation syndrome (OHS). The aim of this study was to assess changes in HMV-user demographics in a regional unit from September 2005 and September 2008. The data was collected prospectively from the electronic discharge summary database. The results are shown below. 341 patients were commenced on HMV over 3 years with an overall increase of 27%; 35% increase in males and a 6% fall in females. Emergency admissions and inpatient transfers from other hospitals to the unit for initiation of HMV increased by 82%. There was no change in the absolute number of NMD, CWD and COPD. We observed a 50% increase in ORRF patients from 2005 to 2008. In conclusion, COPD and ORRF comprise around 70% of the patients initiated on HMV with a substantial increase in the ORRF patients over a 3-year period. As there is limited evidence to support this practice, we must undertake well designed randomised controlled trials to assess the effect of HMV in these two common conditions.
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