Monitoring of Chronic Home Ventilation: Experience based on a Day Hospital Model
Rev. am. med. respir
; 18(3): 162-171, set. 2018. ilus, graf, tab
Article
em En
| LILACS
| ID: biblio-977167
Biblioteca responsável:
AR1.2
ABSTRACT
Introduction:
Home mechanical ventilation (HMV) represents a standard of care for ventilatory pump failure. The standard of care could be a determinant of deficiencies in the quality control of the treatment. Materials andMethods:
In order to monitor compliance during home mechanical ventilation and optimize its effectiveness, we proposed a program through a day hospital conducted by pulmonologists and respiratory physiotherapists. A descriptive study was designed basing on a systematic collection database. Participants were consecutive patients with noninvasive ventilation or invasive mechanical respiratory assistance treated in the Pulmonology Service between July 2014 and December 2016.Results:
94 patients were included 52 men (55%), age 64.4 ± 15.9 years, where 50% were obese or overweight (body mass index of 28.6 ± 8.46 kg / m²). 80 patients (84%) received home mechanical ventilation noninvasive in 77 cases and invasive in three cases (4%). 14 patients (14.8%) were admitted to evaluate the indication of home mechanical ventilation. The following noninvasive ventilation modes were used Bilevel S/T, 59 (62.7%); average volume-assured pressure support ventilation (AVAPS), 4 (4.2%); continuous positive airway pressure (CPAP), 6 (6.4%); servo-ventilation, 1 (1%). Three patients received volumetric ventilation. Mean compliance was 8.1 hours. Four patients did not use the device. 42.5% of patients remained hypercapnic. The setting was changed in 37 patients (46.2%), ventilatory mode was set in 2 (2.5%) and ventilation was suspended in two (2.5%). Adjustments in individual patients were clinically significant.Conclusion:
This program let us improve training and identify a high percentage of patients with ineffective home mechanical ventilation, allowing for adjustments in the modality of treatment.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
LILACS
Assunto principal:
Respiração Artificial
/
Ventilação não Invasiva
Idioma:
En
Revista:
Rev. am. med. respir
Assunto da revista:
MEDICINA
/
PNEUMOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Argentina
País de publicação:
Argentina