Abstract

Home mechanical ventilation (HMV) was traditionally initiated by titration during a hospital admission. Recent studies have shown efficiency when this adaptation is performed on an outpatient basis, with good acceptance and economic savings. The aim of this study was to describe the patients who started VMD in a reference hospital over a period of two years and to compare them, depending on whether they were started on an outpatient or inpatient basis, and to assess the results of the treatment after 6 months.


Retrospective observational study of patients who started HMV from April 2020 to March 2022 in our centre. Outpatient adaptation was carried out in a day hospital, in a shared visit by nurses and doctors. Clinical and ventilatory support data were collected from the clinical history at baseline and 6 months after. Comparative analysis was performed using non-parametric tests.


There were 79 patients included, 52% were male  with a mean age of 67 (SD 14). HMV was initiated in 52 cases on an inpatient (65%) and 27 on an outpatient basis (35%). More frequent diagnosis of COPD and higher previous acute non-invasive ventilation use and higher baseline paCO2 were identified in the inpatient group. The ventilatory mode "pressure support" was always used, mostly with nasobuccal mask (98%). At 6 months, they showed good compliance (7h/day), with no differences amid the groups in transcutaneous CO2.

In our centre, adaptation to HMV is mostly performed on an inpatient basis, especially in patients with COPD. Six months after treatment, hypoventilation control and compliance with therapy are similar in both groups.