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This volume describes the evolution in the home management of severe chronic respiratory insufficiency (CRI) over the last two decades in Italy. It reviews a range of topics including the epidemiological aspects, complicating events, current systems for oxygen delivery with the most convenient interfaces, changing approaches to the patient-caregiver relationship, and the economic burden. Particular attention is paid to the new trends in telemedicine, which is regarded as the future step in respiratory medicine for home-assisted and home-ventilated patients. Data concerning the new role of nursing, the patient’s expectation of life, and the patient’s, family's, and doctor’s perspective are also reported, together with an update on the economic impact of telemedicine and the continuing improvements in the quality of telematic home long-term oxygen treatment.