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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Non-invasive ventilation (NIV) was clearly one of the most relevant developments of Respiratory medicine in the last decades. Acute exacerbations of COPD are among the strongest indications for NIV.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a> For stable COPD, although there are new data pointing to a survival and quality of life benefit,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">2</span></a> there are still some reservations around this indication.</p><p id="par0010" class="elsevierStylePara elsevierViewall">During the national congress of Pulmonology in November 2015, in an interactive session called &#8220;NIV in COPD: why, whom and when&#8221;, we polled approximately 150 participants. The group consisted of 42% Pulmonology specialists, 14% residents, 8% nurses, 20% clinical physiologists, 1% physiotherapists and 15% doctors from other disciplines. About 40% of the participants had been involved in the previous month in the prescription/titration of more than 4 cases of NIV for chronic respiratory failure (CRF) patients. However 25% had had no practice with NIV for CRF in the previous month.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Concerning pressure levels in stable COPD, only 24% of respondents used pressures above 20<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O of IPAP, and the majority (64%) prescribed pressures between 15 and 20<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Importance of procedures performed before prescribing domiciliary NIV for COPD were in 29% a combination of nocturnal SpO<span class="elsevierStyleInf">2</span>, TcCO<span class="elsevierStyleInf">2</span> and sleep studies. Around 20% did not perform any of these.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Initiation and set-up of NIV was done in one third of cases in the outpatient setting in more than one daily session, with 20% performed in the respiratory ward and 19% at home (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Our findings suggest that a wide group of professionals are interested/involved in the prescription of NIV in Portugal. There is some heterogeneity in the experience of prescribing NIV, with a minority of centres (21%) with more than 10 set-ups per month. Only 26% of prescriptions were initiated during elective admission to hospital (respiratory ward or intermediate care unit), supporting the current trend of outpatient NIV initiation.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Prescriptions for high intensity ventilation are low in Portugal. Nocturnal polygraphy with TcCO<span class="elsevierStyleInf">2</span> monitoring should be considered more highly for evaluation and follow-up of these patients.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Reinforcing education in this area together with creation of referral centres specialized in the prescription and control of NIV is highly recommended.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>"
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