Home noninvasive ventilation (NIV) in France. Data from the Antadir-GAV cohort. Results at 18 months

The effectiveness of home NIV for chronic respiratory failure (CRF) is well established. However, little data is available about its epidemiology. The ANTADIR-GAV cohort is aimed to prospectively analyze data from patients initiated to home NIV in France. Methods: Multicentric prospective observational study. Etiology of CRF, demographic data, comorbidities, NIV setting, arterial blood gases, type/parameters of ventilator and interface were collected. Results: From 5/2015 to 12/2016, 964 patients (54% male, age 64±14 y, BMI 28±10 kg/m²) were included in 19 centers. CRF resulted from neuromuscular (51%), thoracic cage (24%) or parenchyma (25%) impairment. The most frequent etiologies were amyotrophic lateral sclerosis (36%), COPD (22%) and obesity hypoventilation (19%). Main comorbidities were hypertension (40%), diabetes (18%), arrhythmia (13%) and coronary heart disease (8%). Before NIV initiation PaO2 was 73±14 and PaCO2 49 ±8 mmHg. Most patients used single circuit pressure ventilators with calibrated leak (99%) and most used modes ST (83%), S (10%) and hybrid (4%). NIV was introduced in 892 patients using a bilevel ventilator without battery (47%) or with battery (45%). A life support ventilator was needed in 8% patients. IPAP, EPAP and backup respiratory rate were respectively 16±4 cmH2O, 7±3 cmH20 and 15±3 c/min. Preferred interface was an orofacial mask (80%). Additional oxygen was needed in 32% patients. NIV was introduced after acute respiratory failure in 43% patients and electively in 57% Conclusion: This cohort gives new insights about recent trends in home NIV practice in France. Recruiting is being pursued and adherence /survival data will be secondarily assessed.