Introduction:
Deventilation syndrome (DVS), defined as increased dyspnoea after cessation of prolonged non-invasive ventilation (NIV), remains a diagnostic and therapeutic challenge. Knowledge of its pathophysiology, prevalence and treatment is limited. This study aimed to characterise patients receiving home NIV, determine DVS prevalence and explore associated factors.

Material and methods:
This nationwide questionnaire-based observational study included patients treated within a home NIV programme and their attending physicians. DVS was defined using criteria based on the modified Borg scale/visual analogue scale and oxygen saturation changes after mask removal. Clinical and ventilatory variables were compared between patients with and without DVS.

Results:
Sixty-five patients were included. DVS was identified in 21 patients (32.3%). Patients with DVS had greater dyspnoea intensity after NIV discontinuation and more often reported dyspnoea lasting more than one hour, immediate discomfort after mask removal and dyspnoea-related limitation of daily functioning. Achieved pressure support was higher in the DVS group than in patients without DVS (15.26 ± 4.78 vs 12.31 ± 3.68 cmH₂O; p=0.020). In exploratory logistic regression, higher achieved pressure support was associated with increased odds of DVS (OR 1.20 per 1 cmH₂O; 95% CI 1.02–1.41; p=0.031). BMI, Mallampati score, frailty, underlying diagnosis, NIV treatment duration and respiratory rate were not significantly associated with DVS.

Conclusions:
DVS affected approximately one-third of patients receiving home NIV and was associated with substantial post-ventilation symptoms. Higher achieved pressure support emerged as the main ventilatory correlate of DVS and requires further investigation.