Non-Invasive Ventilation (NIV)in acute and chronic respiratory failure in Greece

Introduction: NIV has been widely used for the treatment of Acute and Chronic Respiratory Failure (ARF/CRF). This study aimed to evaluate the utilization of NIV in Greece. Methods: A web-based survey was conducted between June and November 2022, exploring NIV implementation in ARF and CRF in pulmonology departments in Greece. This survey was supported by the Hellenic Thoracic Society and the INAB/CERTH (Home Mechanical Ventilation Hellenic Registry). Results: The response rate was 90.4%. Of those, 88% applied NIV in ARF and 66.6% in CRF to patients with obesity hypoventilation syndrome, COPD, heart failure, or neuromuscular diseases. The most common causes of NIV failure in ARF were patients' asynergy (55.6%) and intolerance (55.5%), while poor patients' monitoring and inadequate staff experience/education were also pointed out. Facial and nasal ulcers were the most reported complications. A written detailed algorithm regarding NIV application in ARF was available in 7.9%. Regarding CRF, the following aims of NIV initiation were reported: improvement in patients' QoL ( 68.4%),reduction of hospitalizations(63.2%), improvement of survival (44.7%) and ABGs (42.1%). Criteria for NIV initiation were hospitalization requiring NIV use, clinical worsening, sleep-related breathing disorders, and/or persistent hypercapnia. Concerning NIV use, the education provided to patients and caregivers was 65.8%. At regular patients' follow-up, ABGs and pulmonary function testing were performed on most of the respondents, while technical checks of NIV equipment were handled by the providing company. Conclusions: NIV utilization is common in patients with ARF and CRF in Greece with several variations in the followed procedures.