ABSTRACT
Chronic health care in Europe, like the rest of the developed world, is characterized by an increasingly aging population often with complex medical problems, an increase in societal expectations, and an increase in the dependence on expensive technology. Chronic respiratory failure is no different and is expected to rise in prevalence because of the aging population and possibly because of increased tobacco use. The expansion in Europe (1-3) and the United States (4) over the last three decades in the use of home mechanical ventilation (HMV) mirrors this trend. HMV is used to treat chronic hypercapnic respiratory failure in both adults and children and is usually delivered noninvasively (NIV) with the majority of patients using only nocturnal or nocturnal plus part daytime NIV. NIV has been shown to reduce mortality and morbidity (5,6) and to improve quality of life (7).
