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Letters to the editor
NIV at home: resource implications
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  1. L Turner,
  2. B Cooper,
  3. L Watson,
  4. J Britton,
  5. S Wharton,
  6. W Kinnear
  1. Nottingham Assisted Ventilation Group, University and City Hospitals, Nottingham, UK
  1. Correspondence to
    Dr W Kinnear, University Hospital, Nottingham NG7 2UH, UK;
    kinnear1{at}btopenworld.com

https://doi.org/10.1136/thorax.58.7.644

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    The NHS Modernisation Agency’s critical care programme report “Weaning and long term ventilation”1 recommends that long term non-invasive ventilation (NIV) should be available “according to need” and that this service should increase in line with demand. This need has not been well described. The Nottingham Assisted Ventilation Group (NAVG) provides home NIV for a well defined population of approximately two million. We have looked at the number of patients using NIV at the end of each year between 1991 and 2002 and compared the aetiology of respiratory failure in these patients at the beginning and end of this period.

    All patients used pressure controlled ventilation with NIPPY or BREAS machines. Most patients had chronic ventilatory failure with daytime hypercapnia, but a small number of patients with neuromuscular disease had symptomatic nocturnal hypoventilation with normal daytime arterial blood gases. Patients with obstructive sleep apnoea treated with continuous positive airway pressure (CPAP) were not …

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