RT Journal Article
SR Electronic
T1 Practice of Noninvasive Ventilation for Cystic Fibrosis: A Nationwide Survey in France
JF Respiratory Care
FD American Association for Respiratory Care
SP 1482
OP 1489
VO 53
IS 11
A1 Brigitte Fauroux
A1 Pierre-Régis Burgel
A1 Pierre-Yves Boelle
A1 Claire Cracowski
A1 Marléne Murris-Espin
A1 Raphaele Nove-Josserand
A1 Nathalie Stremler
A1 Laurence Derlich
A1 Philippe Giovanetti
A1 Annick Clément
YR 2008
UL http://rc.rcjournal.com/content/53/11/1482.abstract
AB BACKGROUND: No guidelines are available for noninvasive ventilation (NIV) for cystic fibrosis (CF). OBJECTIVE: To survey and evaluate the use of NIV for CF in France. METHODS: We surveyed the coordinator physicians of every accredited CF center in France. RESULTS: The respondents represented 36 centers (15 pediatric centers, 13 adult centers, and 8 centers that see both pediatric and adult patients), which had a total of 4,416 patients with CF at the time of the study, 168 (3.8%) of whom were using NIV. NIV was being used more often in the adults centers (7.6% of these patients) than in the pediatric centers (1.2% of these patients) or adult-and-pediatric centers (4.1% of these patients) (P = .01). All the respondent centers use NIV as first-line treatment for severe hypercapnic respiratory exacerbation and for stable diurnal hypercapnia, especially when associated with sleep disturbance. Bi-level pressure-targeted ventilation is the preferred ventilation mode. Settings are adjusted based on arterial blood gas values, noninvasive evaluation of patient-ventilator synchrony, patient comfort, and sometimes a sleep study. The surveyed centers reported a number of expected benefits from NIV, but few of those benefits have been proven. Problems with NIV are common and limit its use. CONCLUSIONS: We found a relative homogeneity in these French centers' stated indications for and use of NIV, which highlights their numerous expectations about the benefits of NIV, which contrasts with the few validated benefits. Studies of the benefits of NIV are needed.