Home Mechanical Ventilation (HMV) is well known as a cost-effective treatment which significantly improves quality of life. In this abstract we give an overview of the development of HMV in the Netherlands.
Since 1991 we have been collecting data regarding all patients treated with HMV the Netherlands.
Over the last 20 years, the number of Dutch patients treated with HMV increased from 200 to 2000. There is a significant growth in number of patients treated with non-invasive ventilation. Mask and mouth-piece ventilation in combination with the progress in technical abilities of the equipment, allows patients to use the non-invasive ventilation up to 24 hours a day. Patients were divided in four categories: neuromuscular disease (NMD), thoracic cage restriction (TCR), lung disease and obstructive or central sleep apnea syndrome. Patients with NMD have always been and still remain the largest category in the Netherlands. The rise in NMD is especialy due to patients with ALS; almost 100 patients with ALS started HMV last year. The 2nd largest group includes patients with TCR. Patients with Obesity hypoventilation syndrome (OHS) are primarily responsible for the growth in this group. Patients with obstructive lung disease are a fairly stable group. Of all patients on HMV 83% lives at home.
Most patients on HMV are currently treated non-invasively. The growth of these patients is specifically seen in patients with ALS or OHS. Despite this enormous rise of patients treated with HMV, 83% of the patients still live at home.