Chronic Obstructive Pulmonary Disease and Long-Term Home Non-Invasive Ventilation: Analysis of a Telematically Controlled Unit

Objective: To describe the cohort of COPD patients monitored by Long-Term Home Non-Invasive mechanical ventilation (LTH-NIV), to evaluate the economic impact of the intervention and to determine the existence of clinical or ventilatory variables that are related to the success of the therapy.Methodology: Retrospective observational descriptive study of COPD patients with LTH-NIV with telemonitoring between 2019 and 2022.Results: 68 patients were included, 73% male. Mean age 71 years. Emphysema 60.3% with a mean obstruction of 42.3%; comorbidity prevalence of OSA was 27.7% and AHT 19.5%. Mean PaCO2 before starting LTH-NIV was 57 mmHg; after starting therapy it was 46 mmHg. ST mode with the Resmed® Lumis 150 device. The mean IPAP was 17.04 cmH2O in 98.5%; the mean EPAP was 8.91 cmH2O. Compliance was 7.66 hours and mean leak was 26.65 L/min. In more than half of the patients the PaCO2 was reduced by 20% once the therapy was started, which was significantly associated with a good prognosis. Compliant patients have a lower economic cost. The mean cost of the patients is €8,548 (SD €14,662). AHT was the only comorbidity significantly associated with the failure of LTH-NIV.Conclusions: PaCO2 is not the only variable to be taken into account and specific clinical manifestations, obstruction severity, and certain comorbidities may be critical in determining LTH-NIV indication for COPD patients.