Non-Invasive Ventilation in Hypercapnic Acute Respiratory Failure : Hospital Outcomes And Home Follow-Up

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Published Feb 15, 2026
https://doi.org/10.62438/tunismed.v103i12.6047
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Vol. 103 No. 12 (2025): Tunis Med Dec 2025

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Rim Khemakhem
Department of Pneumology, Hedi Chaker Hospital, University of Sfax, Tunisia
https://orcid.org/0000-0003-4977-6419
Issra Wadhane
Department of Pneumology, Hedi Chaker Hospital, University of Sfax, Tunisia
Rahma Gargouri
Department of Pneumology, Hedi Chaker Hospital, University of Sfax, Tunisia
Hend Abid
Department of Pneumology, Hedi Chaker Hospital, University of Sfax, Tunisia
Sameh Msaad
Department of Pneumology, Hedi Chaker Hospital, University of Sfax, Tunisia
Nessrine Kallel
Department of Pneumology, Hedi Chaker Hospital, University of Sfax, Tunisia
Samy Kammoun
Department of Pneumology, Hedi Chaker Hospital, University of Sfax, Tunisia

Abstract

Introduction: Non-invasive ventilation (NIV) is beneficial in hypercapnic acute respiratory


Failure (ARF) for enhancing alveolar ventilation and reducing the need for intubation. Follow-


Up care is essential for effective management. Our study aims to identify best practices for acute NIV and home follow-up.


Methods :Observation al study of hospitalized patients with hypercapnic ARF treated with NIV


In the Pneumology Department.


Results:We included 64 patients with a sexratioof1.3.The meanage was 66.66±2years.


Respiratory pathologies were dominated by chronic obstructive pulmonary disease (45.3%,


n=29),obesity-hypoventilation syndrome(17.18%,n=11),and bronchiectasis (15.8%,n=10).


On admission,all patients were in respiratory acidosis(pH=7.32±0.04,PaCO2=67.87±11


mmHg,PaO2=55.56±10mmHg).The mean to talduration of NIVuse was7.21days±2.7.


Three groups were defined:group1(G1:46.8%, n=30)(including patients discharged without


Home NIV),group2(G2:26.6%,n=17)including patients discharged on long-term NIV, and


group3(G2:26.6%,n=17)including patients with adelayed indication for NIV. Recurrence


of ARF was noted in26.56% of patients(n=17).Themortality ratewas7.8%(n=5).


Conclusion: A protocol for monitoring and prescribing NIV at home is needed to improve


Quality of life and survival and prevent ARF recurrence.

Keywords:

Non-invasive ventilation, Acute respiratory failure, Positive expiratory pressure, Inspiratory support, Hypercapnia

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