SESSION TITLE: Non-Invasive Ventilation
SESSION TYPE: Slide Presentations
PRESENTED ON: Saturday, March 22, 2014 at 12:15 PM - 01:15 PM
PURPOSE: Our objective is to investigate the outcome of HMV in ≥ 75 years to determine if there are differences respect to younger patients.
METHODS: Prospective study of patients ≥ 75 years (Group A) included in a HMV program (January 2007 - July 2012). We collected many variables and patients were followed until October 2012. Patients were compared with < 75 years (group B) in the same period.
RESULTS: We included 54 patients in group A (77,8% female) and 188 in group B (48,4% women). Hypertension (77,8% in A vs 63,8% in B, p = 0,05) and heart disease (55,6% in A vs 37,8% in B, p = 0,028) were more common in group A. We found no differences in the presence of severe Obstructive Sleep Apnea, level of consciousness on admission, PaO2 or PaCO2, adaptation to ventilation at admission or discharge. Main reasons for starting ventilation in group A were: Obesity-Hypoventilation Syndrome (70,4%) and restrictive diseases (14,8%). Mean follow-up was similar in both groups and there was no difference between the two groups in level of IPAP, average hours of use, PaO2 or PaCO2 during follow-up or number of readmissions. Patients in group A had a poor compliance (50% in A vs B: 35,6; p = 0,06) and required oxygen therapy more frequently (72,2 in A vs B: 57,4%; p = 0,058). Quality of life was worse in group A (poor quality of life in group A 37% vs B: 22,3%, p = 0,03). Both groups had long survival but it was lower in group A (median 151 ± 28 weeks vs B: 277 ± 62,6 weeks; p = 0,06).
CONCLUSIONS: 1.- In our experience, HMD is an effective and, in general, well tolerated therapy in elderly patients. 2.- We obtained long survival among these patients even though their compliance profile was poor.
CLINICAL IMPLICATIONS: It has been noted that employ of home mechanical ventilation (HMV) in elderly patients is not recommended for their low life expectancy and their poor adaptation.
DISCLOSURE: The following authors have nothing to disclose: María del Carmen García García, Jacinto Hernández Borge, Pedro Pires Goncalves, Estefanía Molina Ortiz, Pilar Cordero Montero, María Teresa Gómez Vizcaíno, Francisca Lourdes Márquez Pérez, José Antonio Marín Torrado, Ana Castañar Jover, Ignacio Rodríguez Blanco
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