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. 2023 Feb 27;9(1):00438-2022.
doi: 10.1183/23120541.00438-2022. eCollection 2023 Jan.

At-home noninvasive ventilation initiation with telemonitoring in amyotrophic lateral sclerosis patients: a retrospective study

Thomas Réginault  1   2 , Benoit Bouteleux  2 , Philippe Wibart  1   2 , Stéphane Mathis  3 , Gwendal Le Masson  3 , Odile Pillet  1 , Léo Grassion  4
Affiliations

At-home noninvasive ventilation initiation with telemonitoring in amyotrophic lateral sclerosis patients: a retrospective study

Thomas Réginault et al. ERJ Open Res. .

Abstract

Background: Noninvasive ventilation (NIV) improves survival and quality of life in amyotrophic lateral sclerosis (ALS) patients. NIV initiation is mostly conducted at hospital, but a recurrent lack of hospital beds led to the necessity of exploring an at-home initiation process. Here, we report data from our NIV initiation cohort of ALS patients. Could our at-home NIV initiation process with telemonitoring in ALS patients be an efficient solution for adherence and nocturnal hypoxaemia correction?

Methods: We performed a retrospective analysis of data collected from 265 ALS patients treated at the Bordeaux ALS Centre for whom NIV initiation was carried out between September 2017 and June 2021, with two modalities: at-home initiation or in-hospital initiation. The primary outcome was adherence to NIV at 30 days. The secondary outcome was at-home NIV initiation process efficiency of nocturnal hypoxaemia correction.

Results: At 30 days, NIV adherence (mean >4 h·day-1) was 66% of the total population, 70% of the at-home NIV initiation subgroup and 52% of the in-hospital NIV initiation subgroup. Nocturnal hypoxaemia correction was observed in 79% of adherent patients in the at-home NIV initiation subgroup. Mean delay of NIV prescription and at-home NIV initiation was 8.7 days (+/-6.5) versus 29.5 days in hospital.

Conclusion: Our study shows that our at-home NIV initiation process in ALS patients is a good option to provide rapid access to NIV with good adherence and efficiency. Further literature on the benefits of at-home NIV initiation is welcomed, especially to evaluate long-term efficiency and global cost analysis.

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Conflict of interest statement

Conflict of interest: T. Réginault reports support for the present manuscript from the Bordeaux University Foundation; and travel support from Vivisol and personal fees from Zéphyr Paramed, outside the submitted work. B. Bouteleux reports personal fees from Zéphyr Paramed outside the submitted work. P. Wibart reports support for the present manuscript from the Bordeaux University Foundation, and personal fees from Zéphyr Paramed outside the submitted work. L. Grassion received grants or contracts from AADAIRC, outside the submitted work; payment of honoraria for lectures, presentations, speakers' bureaus, manuscript writing or educational events from SOS Oxygene, ASTEN Santé, and ALMS, outside the submitted work; support for attending meetings and/or travel from SOS Oxygen, VIVISOL and ASTEN Santé, outside the submitted work; and participation on a data safety monitoring board or advisory board for VIVISOL, outside the submitted work. All other authors have nothing to disclose.

Figures

FIGURE 1
FIGURE 1
At-home noninvasive ventilation (NIV) initiation protocol. Five steps that comprise at-home NIV initiation with a nonexhaustive description of the actions performed by the different actors.
FIGURE 2
FIGURE 2
Flowchart of patients included between September 2017 and June 2021. ALS: amyotrophic lateral sclerosis; NIV: noninvasive ventilation.
See this image and copyright information in PMC

References

    1. Arnulf I, Similowski T, Salachas F, et al. . Sleep disorders and diaphragmatic function in patients with amyotrophic lateral sclerosis. Am J Respir Crit Care Med 2000; 161: 849–856. doi:10.1164/ajrccm.161.3.9805008 - DOI - PubMed
    1. Gil J, Funalot B, Verschueren A, et al. . Causes of death amongst French patients with amyotrophic lateral sclerosis: a prospective study. Eur J Neurol 2008; 15: 1245–1251. doi:10.1111/j.1468-1331.2008.02307.x - DOI - PubMed
    1. Perez T. [Amyotrophic lateral sclerosis (ALS): evaluation of respiratory function]. Rev Neurol (Paris) 2006; 162: Spec. No. 2, 4S188–4S194. - PubMed
    1. Bourke SC, Tomlinson M, Williams TL, et al. . Effects of non-invasive ventilation on survival and quality of life in patients with amyotrophic lateral sclerosis: a randomised controlled trial. Lancet Neurol 2006; 5: 140–147. doi:10.1016/S1474-4422(05)70326-4 - DOI - PubMed
    1. Morelot-Panzini C, Bruneteau G, Gonzalez-Bermejo J. NIV in amyotrophic lateral sclerosis: The “when” and “how” of the matter. Respirology 2019; 24: 521–530. doi:10.1111/resp.13525 - DOI - PubMed

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