[Effectiveness of domiciliary noninvasive positive pressure ventilation in improving blood gas levels and the performance of daily activities. NIPPV Study Group].

Noninvasive positive pressure ventilation (NIPPV) is widely used in the domiciliary treatment of chronic ventilatory failure. We conducted a multicenter, prospective study of the effects of NIPPV on blood gas levels, subjective symptoms, and the performance of daily activities. Fifty-one hospitalized patients with chronic ventilatory failure were enrolled in the study. Using NIPPV, 44 patients were able to live at home for more than 1 month, and 43 for more than 3 months. PaO2 and PaCO2 were 69.1 +/- 13.1 Torr (n = 25) and 70.8 +/- 11.0 Torr (n = 27) before NIPPV and 77.9 +/- 12.5 Torr (n = 26) and 61.0 +/- 11.2 Torr (n = 27) after 1 month of domiciliary treatment, respectively. Blood gas values were significantly improved after NIPPV. Patients experienced alleviation of all subjective symptoms. Dyspnea when wearing clothes, walking on flat levels, or climbing stairs also subsided, and was significantly reduced during daily activities other than eating among those patients who needed any help in performing their activities prior to the initiation of NIPPV. We concluded that NIPPV is an effective and convenient means of domiciliary ventilation that can help patients achieve greater independence in daily life. NIPPV can be expected to play a central role in home respiratory care for patients with hypercapnic respiratory failure.