Aims and objectives: long-term non-invasive ventilation (LT-NIV) might be recommended in COPD with hypercapnia. However COPD therapeutic compliance is poor. The main objective of the VentiObs study was to study the observance of LT-NIV in COPD.

Method

Prospective observational study through 11 hospitals, including COPD receiving LT-NIV according to the physician in charge and recommendations. After inclusion patients were followed at 1 month, 6 and 12 months. Devices and health care professionals were provided by Vivisol France, France Oxygène, MBAR companies.

We collected: compliance to LT-NIV, dyspnoea scale (mMRC), QoL (VQ11), patient?s acceptance to LT-NIV survey (S3-NIV), respiratory function, haematosis.

Results

25 patients were included. 20 patients were analysed at V1 (10 men, median age 70y (IQR = 61-88), median FEV1 44% of theoretical (28?67), median PaO2 54mmHg (52?77), PaCO2 50mmHg (46.5?68), 16 at V2, 12 at V3. LT-NIV was introduced after acute exacerbation in 80% of case. Initial setting for IPAP and EPAP were respectively 13 and 5 cmH2O.

Compliance was considered correct if NIV was used > 4h/d (75% of patients at V1, 81% at V2, 82% at V3). Between V1 and V3 compliance increased by 58min/d. Observers used NIV for 29.6 d, non-observers for 18 d/month.

A decrease in dyspnea was observed at V2. QoL, haematosis and FEV1 improved. Use of health care providers was 11.6 times/patient-year.

Conclusions

These data on LT-NIV for COPD in real life in a limited number of patients indicate satisfactory compliance. If the NIV was put on, it was for an extended period, but it can be forgotten overnight. Quality of life was poor and little modified, although respiratory and NIV tolerances were correct.