Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/26000
Title: Typical within and between person variability in non-invasive ventilator derived variables among clinically stable, long-term users.
Austin Authors: Jeganathan, Vishnu ;Rautela, Linda ;Conti, Simon;Saravanan, Krisha;Rigoni, Alyssa;Graco, Marnie ;Hannan, Liam M ;Howard, Mark E ;Berlowitz, David J 
Affiliation: Respiratory and Sleep Medicine
Physiotherapy
Institute for Breathing and Sleep
Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
Respiratory Medicine, Northern Health, Epping, Victoria, Australia
Issue Date: Mar-2021
metadata.dc.date: 2021-03
Publication information: BMJ Open Respiratory Research 2021; 8(1): e000824
Abstract: Despite increasing capacity to remotely monitor non-invasive ventilation (NIV), how remote data varies from day to day and person to person is poorly described. Single-centre, 2-month, prospective study of clinically stable adults on long-term NIV which aimed to document NIV-device variability. Participants were switched to a ventilator with tele-monitoring capabilities. Ventilation settings and masking were not altered. Raw, extensible markup language data files were provided directly from Philips Respironics (EncoreAnywhere). A nested analysis of variance was conducted on each ventilator variable to apportion the relative variation between and within participants. Twenty-nine people were recruited (four withdrew, one had insufficient data for analyses; 1364 days of data). Mean age was 54.0 years (SD 18.4), 58.3% male with body mass index of 37.0 kg/m2 (13.7). Mean adherence was 8.53 (2.23) hours/day and all participants had adherence >4 hours/day. Variance in ventilator-derived indices was predominantly driven by differences between participants; usage (61% between vs 39% within), Apnoea-Hypopnoea Index (71% vs 29%), unintentional (64% vs 36%) and total leak (83% vs 17%), tidal volume (93% vs 7%), minute ventilation (92% vs 8%), respiratory rate (92% vs 8%) and percentage of triggered breaths (93% vs 7%). In this clinically stable cohort, all device-derived indices were more varied between users than the day-to-day variation within individuals. We speculate that normative ranges and thresholds for clinical intervention need to be individualised, and further research is necessary to determine the clinically important relationships between clinician targets for therapy and patient-reported outcomes.
URI: https://ahro.austin.org.au/austinjspui/handle/1/26000
DOI: 10.1136/bmjresp-2020-000824
ORCID: 0000-0003-2543-8722
PubMed URL: 33664121
Type: Journal Article
Subjects: assisted ventilation
clinical epidemiology
non invasive ventilation
Appears in Collections:Journal articles

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