Table 1.

Reasons Cited for Selection of HMV Over BPAP Devices

•Respiratory therapist support in the home is not available with BPAP devices

•Physicians and homecare companies feel that the current RAD/bilevel criteria are so obstructive that an HMV is easier to approve

•Current RAD/bilevel criteria are out of date with the medical standards, especially for ALS

•Historically, volume-cycled modes of ventilation were used exclusively to treat patients when the data encourage an early start for NIV with NMD

•Desire to use HMV early in the course of disease to facilitate lung volume recruitment

•Health care providers in rural areas or hurricane zones require assured battery backup

ALS = amyotrophic lateral sclerosis; BPAP = bilevel positive airway pressure; HMV = home mechanical ventilation; NIV = noninvasive ventilation; NMD = neuromuscular disease; RAD = respiratory assist device.