Title 1615_21Mar25_Piper A_Update in NIV.pdf ✅

Update in NIV Amanda Piper, PhD Respiratory Support Service Royal Prince Alfred Hospital Camperdown Australia 1

• Inpatient acclimation common approach in many regions • Especially when initiating high intensity-NIV (Struik, Thorax 2014; Murphy, JAMA 2017; Kohnlein, Lancet Repir Med 2014) • Needed to titrate a substantial ↓PaCO2 comfortably • LOHS often up to 7 days (Duiverman, Thorax 2020; Kohnlein, Lancet Respir Med 2014) • Cost and health resource implications • Interest in alternative models of NIV initiation • Improve access to therapy without compromising outcomes Location of initiation of home NIV vs 3
Location of initiation of home NIV Duiverman, Thorax 2020 • RCT of 67 stable hypercapnic COPD: Home vs hospital initiation of NIV • ∆ PaCO2 at 6 m Home NIV non- inferior 0.04kPa (95% CI -0.31 to 0.38) 4