Followup

Clinical follow-up and daytime arterial blood gas (ABG) measurements (or their surrogates) should be conducted regularly (two times per year for example). When possible, recordings during sleep on NIPPV, identical to those used for initiating NIPPV are useful. At any time, when there are unsatisfactory results like recurrence of clinical symptoms or hypoventilation on ABG, inadequate NIPPV must be suspected and objective evaluation during sleep must be undertaken. At the very least, overnight oximetry must be done. When NIPPV is determined to be suboptimal, a change in ventilator modality or setting and a review of the mask fitting may be indicated. Increasing the total duration of NIPPV use per day should also be considered, particularly when the underlying disease has progressed. Masks have to be regularly checked and changed or adapted as needed.

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