Long-Term Non-invasive Ventilation: Do Patients Aged Over 75 Years Differ From Younger Adults?
Background: Noninvasive ventilation (NIV) is accepted as standard of care for chronic hypercapnic respiratory failure (CHRF) and is being increasingly implemented in older subjects. However, little is known regarding the use of NIV on a long-term basis in the very old. The outcomes of this study wer...
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| Format: | Article |
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Frontiers Media S.A.
2020-11-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2020.556218/full |
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| author | Chloé Cantero Dan Adler Dan Adler Patrick Pasquina Christophe Uldry Bernard Egger Maura Prella Alain Bigin Younossian Paola Soccal-Gasche Paola Soccal-Gasche Jean-Louis Pépin Jean-Louis Pépin Jean-Paul Janssens Jean-Paul Janssens |
| author_facet | Chloé Cantero Dan Adler Dan Adler Patrick Pasquina Christophe Uldry Bernard Egger Maura Prella Alain Bigin Younossian Paola Soccal-Gasche Paola Soccal-Gasche Jean-Louis Pépin Jean-Louis Pépin Jean-Paul Janssens Jean-Paul Janssens |
| author_sort | Chloé Cantero |
| collection | DOAJ |
| description | Background: Noninvasive ventilation (NIV) is accepted as standard of care for chronic hypercapnic respiratory failure (CHRF) and is being increasingly implemented in older subjects. However, little is known regarding the use of NIV on a long-term basis in the very old. The outcomes of this study were: 1/to report the proportion of patients ≥ 75 years old (elderly) among a large group of long-term NIV users and its trend since 2000; 2/to compare this population to a younger population (<75 years old) under long-term NIV in terms of diagnoses, comorbidities, anthropometric data, technical aspects, adherence to and efficiency of NIV.Methods: In a cross-sectional analysis of a multicenter cohort study on patients with CHRF under NIV, diagnoses, comorbidities, technical aspects, adherence to and efficiency of NIV were compared between patients ≥ 75 and <75 years old (chi-square or Welch Student tests).Results: Of a total of 489 patients under NIV, 151 patients (31%) were ≥ 75 years of age. Comorbidities such as systemic hypertension (86 vs. 60%, p < 0.001), chronic heart failure (30 vs. 18%, p = 0.005), and pulmonary hypertension (25 vs. 14%, p = 0.005) were more frequent in older subjects. In the older group, there was a trend for a higher prevalence of chronic obstructive pulmonary disease (COPD) (46 vs. 36%, p = 0.151) and a lower prevalence of neuromuscular diseases (NMD) (19 vs. 11%, p = 0.151), although not significant. Adherence to and efficacy of NIV were similar in both groups (daily use of ventilator: 437 vs. 419 min, p = 0.76; PaCO2: 5.8 vs. 5.9 kPa, p = 0.968). Unintentional leaks were slightly higher in the older group (1.8 vs. 0.6 L/min, p = 0.018).Conclusions: In this cross-sectional study, one third of the population under NIV was ≥ 75 years old. Markers of efficacy of NIV, and adherence to treatment were similar when compared to younger subjects, confirming the feasibility of long-term NIV in the very old. Health-related quality of life was not assessed in this study and further research is needed to address this issue. |
| first_indexed | 2024-12-23T10:57:03Z |
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| language | English |
| last_indexed | 2024-12-23T10:57:03Z |
| publishDate | 2020-11-01 |
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| spelling | doaj.art-cf1dc58b57b34a5f8580a428ba1401392022-12-21T17:49:45ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2020-11-01710.3389/fmed.2020.556218556218Long-Term Non-invasive Ventilation: Do Patients Aged Over 75 Years Differ From Younger Adults?Chloé Cantero0Dan Adler1Dan Adler2Patrick Pasquina3Christophe Uldry4Bernard Egger5Maura Prella6Alain Bigin Younossian7Paola Soccal-Gasche8Paola Soccal-Gasche9Jean-Louis Pépin10Jean-Louis Pépin11Jean-Paul Janssens12Jean-Paul Janssens13Division of Pulmonary Diseases, Geneva University Hospitals (HUG), Geneva, SwitzerlandDivision of Pulmonary Diseases, Geneva University Hospitals (HUG), Geneva, SwitzerlandFaculty of Medicine, University of Geneva, Geneva, SwitzerlandDivision of Pulmonary Diseases, Geneva University Hospitals (HUG), Geneva, SwitzerlandDivision of Pulmonary Diseases and Pulmonary Rehabilitation Center, Rolle Hospital Rolle, Vaud, SwitzerlandDivision of Pulmonary Diseases and Pulmonary Rehabilitation Center, Rolle Hospital Rolle, Vaud, SwitzerlandDivision of Pulmonary Diseases, Lausanne University Hospital (CHUV), Lausanne, SwitzerlandDivision of Pulmonary Diseases and Intensive Care, La Tour Hospital, Geneva, SwitzerlandDivision of Pulmonary Diseases, Geneva University Hospitals (HUG), Geneva, SwitzerlandFaculty of Medicine, University of Geneva, Geneva, SwitzerlandHP2 Laboratory, Inserm U1042 Unit, University Grenoble Alps, Grenoble, FranceEFCR Laboratory, Thorax and Vessels, Grenoble Alps University Hospital, Grenoble, FranceDivision of Pulmonary Diseases, Geneva University Hospitals (HUG), Geneva, SwitzerlandFaculty of Medicine, University of Geneva, Geneva, SwitzerlandBackground: Noninvasive ventilation (NIV) is accepted as standard of care for chronic hypercapnic respiratory failure (CHRF) and is being increasingly implemented in older subjects. However, little is known regarding the use of NIV on a long-term basis in the very old. The outcomes of this study were: 1/to report the proportion of patients ≥ 75 years old (elderly) among a large group of long-term NIV users and its trend since 2000; 2/to compare this population to a younger population (<75 years old) under long-term NIV in terms of diagnoses, comorbidities, anthropometric data, technical aspects, adherence to and efficiency of NIV.Methods: In a cross-sectional analysis of a multicenter cohort study on patients with CHRF under NIV, diagnoses, comorbidities, technical aspects, adherence to and efficiency of NIV were compared between patients ≥ 75 and <75 years old (chi-square or Welch Student tests).Results: Of a total of 489 patients under NIV, 151 patients (31%) were ≥ 75 years of age. Comorbidities such as systemic hypertension (86 vs. 60%, p < 0.001), chronic heart failure (30 vs. 18%, p = 0.005), and pulmonary hypertension (25 vs. 14%, p = 0.005) were more frequent in older subjects. In the older group, there was a trend for a higher prevalence of chronic obstructive pulmonary disease (COPD) (46 vs. 36%, p = 0.151) and a lower prevalence of neuromuscular diseases (NMD) (19 vs. 11%, p = 0.151), although not significant. Adherence to and efficacy of NIV were similar in both groups (daily use of ventilator: 437 vs. 419 min, p = 0.76; PaCO2: 5.8 vs. 5.9 kPa, p = 0.968). Unintentional leaks were slightly higher in the older group (1.8 vs. 0.6 L/min, p = 0.018).Conclusions: In this cross-sectional study, one third of the population under NIV was ≥ 75 years old. Markers of efficacy of NIV, and adherence to treatment were similar when compared to younger subjects, confirming the feasibility of long-term NIV in the very old. Health-related quality of life was not assessed in this study and further research is needed to address this issue.https://www.frontiersin.org/articles/10.3389/fmed.2020.556218/fullnon-invasive ventilationelderlyprevalencecompliancechronic obstrucive pulmonary diseaseobesity hypoventilation syndrome |
| spellingShingle | Chloé Cantero Dan Adler Dan Adler Patrick Pasquina Christophe Uldry Bernard Egger Maura Prella Alain Bigin Younossian Paola Soccal-Gasche Paola Soccal-Gasche Jean-Louis Pépin Jean-Louis Pépin Jean-Paul Janssens Jean-Paul Janssens Long-Term Non-invasive Ventilation: Do Patients Aged Over 75 Years Differ From Younger Adults? Frontiers in Medicine non-invasive ventilation elderly prevalence compliance chronic obstrucive pulmonary disease obesity hypoventilation syndrome |
| title | Long-Term Non-invasive Ventilation: Do Patients Aged Over 75 Years Differ From Younger Adults? |
| title_full | Long-Term Non-invasive Ventilation: Do Patients Aged Over 75 Years Differ From Younger Adults? |
| title_fullStr | Long-Term Non-invasive Ventilation: Do Patients Aged Over 75 Years Differ From Younger Adults? |
| title_full_unstemmed | Long-Term Non-invasive Ventilation: Do Patients Aged Over 75 Years Differ From Younger Adults? |
| title_short | Long-Term Non-invasive Ventilation: Do Patients Aged Over 75 Years Differ From Younger Adults? |
| title_sort | long term non invasive ventilation do patients aged over 75 years differ from younger adults |
| topic | non-invasive ventilation elderly prevalence compliance chronic obstrucive pulmonary disease obesity hypoventilation syndrome |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2020.556218/full |
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