[Assisted ventilation at home for chronic respiratory insufficient patients in the Languedoc-Roussillon area (357 observations) (author's transl)].

Up to May 31, 1978, 357 patients with restrictive (77 cases), obstructive (138 cases) or mixed (142 cases) respiratory insufficiency were given assisted ventilation at home. Only those patients whose PaCO2 could not be stabilized by drug therapy, physical therapy and/or oxygenotherapy, were selected. Seventy-five tracheostomized patients were ventilated endotracheally using a volume generator with fixed frequency in an 8-hour session during sleep. Two hundred and eighty-two subjects were ventilated through a mouth-piece using either a volume generator with synchronizable frequency or a pressure relaxator (self-regulated ventilation) distributed in several day-time session for a total of 4 hours daily. Six months after the onset of home ventilation, a marked decrease of PaCO2 is observed in all the groups regardless of the ventilation method. This improvement is maintained after wards. Furthermore, a decrease in the average length of hospitalization is noted. After 2 years the survival percentage is 77.7%; after 5 years it is 52.3%. The patients who benefit most from assisted ventilation are those suffering from restrictive respiratory insufficiency submitted to endotracheal ventilation (more than 70% of survivals after 9 years). Long-term results are not so good for the obstructive or mixed respiratory insufficiencies, especially when an important bronchospasm and/or a large bronchorrhea is present.