Typical within and between person variability in non-invasive ventilator derived variables among clinically stable, long-term users.

Autor:	Jeganathan V; Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia.; Respiratory and Sleep Medicine, Institute for Breathing and Sleep, Heidelberg, Victoria, Australia., Rautela L; Respiratory and Sleep Medicine, Institute for Breathing and Sleep, Heidelberg, Victoria, Australia.; Department of Physiotherapy, Austin Health, Heidelberg, Victoria, Australia., Conti S; Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia.; Respiratory and Sleep Medicine, Institute for Breathing and Sleep, Heidelberg, Victoria, Australia., Saravanan K; Respiratory and Sleep Medicine, Institute for Breathing and Sleep, Heidelberg, Victoria, Australia., Rigoni A; Respiratory and Sleep Medicine, Institute for Breathing and Sleep, Heidelberg, Victoria, Australia., Graco M; Institute for Breathing and Sleep, Heidelberg, Victoria, Australia.; Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia., Hannan LM; Respiratory and Sleep Medicine, Institute for Breathing and Sleep, Heidelberg, Victoria, Australia.; Respiratory Medicine, Northern Health, Epping, Victoria, Australia., Howard ME; Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia.; Respiratory and Sleep Medicine, Institute for Breathing and Sleep, Heidelberg, Victoria, Australia.; Institute for Breathing and Sleep, Heidelberg, Victoria, Australia., Berlowitz DJ; Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia david.berlowitz@austin.org.au.; Respiratory and Sleep Medicine, Institute for Breathing and Sleep, Heidelberg, Victoria, Australia.; Institute for Breathing and Sleep, Heidelberg, Victoria, Australia.; Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.
Jazyk:	angličtina
Zdroj:	BMJ open respiratory research [BMJ Open Respir Res] 2021 Mar; Vol. 8 (1).
DOI:	10.1136/bmjresp-2020-000824
Abstrakt:	Background: Despite increasing capacity to remotely monitor non-invasive ventilation (NIV), how remote data varies from day to day and person to person is poorly described. Methods: Single-centre, 2-month, prospective study of clinically stable adults on long-term NIV which aimed to document NIV-device variability. Participants were switched to a ventilator with tele-monitoring capabilities. Ventilation settings and masking were not altered. Raw, extensible markup language data files were provided directly from Philips Respironics (EncoreAnywhere). A nested analysis of variance was conducted on each ventilator variable to apportion the relative variation between and within participants. Results: Twenty-nine people were recruited (four withdrew, one had insufficient data for analyses; 1364 days of data). Mean age was 54.0 years (SD 18.4), 58.3% male with body mass index of 37.0 kg/m 2 (13.7). Mean adherence was 8.53 (2.23) hours/day and all participants had adherence >4 hours/day. Variance in ventilator-derived indices was predominantly driven by differences between participants; usage (61% between vs 39% within), Apnoea-Hypopnoea Index (71% vs 29%), unintentional (64% vs 36%) and total leak (83% vs 17%), tidal volume (93% vs 7%), minute ventilation (92% vs 8%), respiratory rate (92% vs 8%) and percentage of triggered breaths (93% vs 7%). Interpretation: In this clinically stable cohort, all device-derived indices were more varied between users than the day-to-day variation within individuals. We speculate that normative ranges and thresholds for clinical intervention need to be individualised, and further research is necessary to determine the clinically important relationships between clinician targets for therapy and patient-reported outcomes. Competing Interests: Competing interests: Phillips Respironics provided NIV devices for the trial and downloads of the online participant data as “in-kind” support. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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