• Chloé Cantero, Dan Adler, Patrick Pasquina, Christophe Uldry, Bernard Egger, Maura Prella, Alain B Younossian, Paola M Soccal, Jean-Louis Pépin, and Jean-Paul Janssens.
• Division of Pulmonary Diseases, Geneva University Hospitals (HUG), Geneva, Switzerland.
• Chest. 2020 Jul 1; 158 (1): 279-291.

BackgroundNoninvasive ventilation (NIV) is standard of care for chronic hypercapnic respiratory failure, but indications, devices, and ventilatory modes are in constant evolution.Research QuestionTo describe changes in prevalence and indications for NIV over a 15-year period; to provide a comprehensive report of characteristics of the population treated (age, comorbidities, and anthropometric data), mode of implementation and follow-up, devices, modes and settings used, physiological data, compliance, and data from ventilator software.Study Design And MethodsCross-sectional observational study designed to include all subjects under NIV followed by all structures involved in NIV in the Cantons of Geneva and Vaud (1,288,378 inhabitants).ResultsA total of 489 patients under NIV were included. Prevalence increased 2.5-fold since 2000 reaching 38 per 100,000 inhabitants. Median age was 71 years, with 31% being > 75 years of age. Patients had been under NIV for a median of 39 months and had an average of 3 ± 1.8 comorbidities; 55% were obese. COPD (including overlap syndrome) was the most important patient group, followed by obesity hypoventilation syndrome (OHS) (26%). Daytime Paco2 was most often normalized. Adherence to treatment was satisfactory, with 8% only using their device < 3.5 h/d. Bilevel positive pressure ventilators in spontaneous/timed mode was the default mode (86%), with a low use of autotitrating modes. NIV was initiated electively in 50% of the population, in a hospital setting in 82%, and as outpatients in 15%.InterpretationUse of NIV is increasing rapidly in this area, and the population treated is aging, comorbid, and frequently obese. COPD is presently the leading indication followed by OHS.Trial RegistryClinicalTrials.gov; No.: NCT04054570; URL: www.clinicaltrials.gov.Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

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