The Feasibility of Domiciliary Non-Invasive Mechanical Ventilation due to Chronic Respiratory Failure in Very Elderly Patients

OBJECTIVES: The aim of this study was to investigate the use of domiciliary non-invasive mechanical ventilation (NIMV) in very elderly patients (age 80 and over). MATERIALS AND METHODS: This retrospective study included a total of 44 patients aged 80 years or older, who were admitted to the Health Sciences University, Sureyyapsa Chest Diseases and Thoracic Surgery Training and Research Hospital, Pulmonary Intensive Care Outpatient Clinic between 2012 and 2018 and applied NIMV for chronic respiratory failure. The patients were divided into two groups: survivors (n=15) and non-survivors (n=29). Data were obtained from the retrospectively formed hospital database. The characteristics of patients, comorbidities, NIMV compliance, pulmonary function tests, and blood gas analyses were compared between the survivors and non-survivors. RESULTS: From the retrospective analysis of 44 cases, the non-survivors were found to have a significantly shorter duration of domiciliary NIMV (737 days vs. 890 days, p=0.027) and lower hemoglobin concentration (11.1 g/L vs. 12.9 g/L, p=0.004). The number of comorbid conditions, pulmonary function test, and blood gas analyses results did not differ significantly between the groups. Compliance was moderate in this elderly population, at 4.9 +/- 1.9 h/day (range: 0.8-9.1 h/day). NIMV was well-tolerated in 36 of the 44 elderly patients (81.8%). Overall mortality was 65.9%. CONCLUSION: Domiciliary NIMV can be of benefit to very elderly patients, and age is not an obstacle. Therefore, this population should not be excluded from this treatment solely on the basis of age.