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home mechanical ventilation

Michele Vitacca, Luca Barbano, Daniele Colombo, Olivia Leoni, Enrico Guffanti
Few studies have analyzed the prevalence and accessibility of home mechanical ventilation (HMV) in Italy. We aimed to investigate the prevalence and prescription variability of HMV as well as of long-term oxygen therapy (LTOT) and continuous positive airway pressure (CPAP), in the Lombardy Region. Prescribing rates of HMV (both noninvasive and tracheostomies), CPAP (auto-CPAP, CPAP/other sleep machines) and LTOT (liquid-O2, O2-gas, concentrators) in the 15 Local Healthcare districts of Lombardy were gathered from billing data for 2012 and compared...
January 29, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Sophie Emilia Huttmann, Friederike Sophie Magnet, Christian Karagiannidis, Jan Hendrik Storre, Wolfram Windisch
BACKGROUND: Health-related quality of life (HRQL), life satisfaction, living conditions, patients' attitudes towards life and death, expectations, beliefs and unmet needs are all poorly understood aspects associated with patients receiving invasive home mechanical ventilation (HMV) following ICU treatment and unsuccessful weaning. Therefore, the present study aimed to assess (1) HRQL, (2) life satisfaction and (3) patients' perspectives on life and death associated with invasive HMV as the consequence of unsuccessful weaning...
March 16, 2018: Annals of Intensive Care
Rafael Arboleda Salazar, Jane Heggie, Piotr Wolski, Eric Horlick, Mark Osten, Massimiliano Meineri
BACKGROUND: Twenty percent of patients born with congenital heart disease present with right ventricular outflow tract abnormalities. These patients require multiple surgical procedures in their lifetime. Transcatheter pulmonary valve replacement (TPVR) has become a viable alternative to conventional pulmonary valve and right ventricular outflow tract surgery in pediatric and adult populations. In this retrospective review, we analyze the perioperative management of adult patients who underwent TPVR in our center...
March 14, 2018: Anesthesia and Analgesia
Jan Hendrik Storre, Jens Callegari, Friederike Sophie Magnet, Sarah Bettina Schwarz, Marieke Leontine Duiverman, Peter Jan Wijkstra, Wolfram Windisch
Long-term or home mechanical noninvasive ventilation (Home-NIV) has become a well-established form of therapy over the last few decades for chronic hypercapnic COPD patients in European countries. However, meta-analyses and clinical guidelines do not recommend Home-NIV for COPD patients on a routine basis. In particular, there is ongoing debate about Home-NIV in chronic hypercapnic COPD regarding the overall effects, the most favorable treatment strategy, the selection of eligible patients, and the time point at which it is prescribed...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Balagangadhar R Totapally, Ashish H Shah, Toba Niazi
OBJECTIVE: Posterior fossa tumor surgery in children poses a significant morbidity and mortality. Large multi-institutional datasets characterizing the epidemiology and morbidity of children undergoing posterior fossa tumor surgery are lacking. The objective of this study is to describe the epidemiology and short term surgical outcomes of children presenting with cerebellar tumors. PATIENTS AND METHODS: A retrospective review of the Kids Inpatient Database (KID) for all hospital discharges in 2012 with a diagnosis of cerebellar tumor (ICD-9 diagnosis code 191...
February 26, 2018: Clinical Neurology and Neurosurgery
Stephanie K Mansell, Steven Cutts, Isobel Hackney, Martin J Wood, Kevin Hawksworth, Dean D Creer, Cherry Kilbride, Swapna Mandal
Introduction: Ventilation parameter data from patients receiving home mechanical ventilation can be collected via secure data cards and modem technology. This can then be reviewed by clinicians and ventilator prescriptions adjusted. Typically available measures include tidal volume (VT ), leak, respiratory rate, minute ventilation, patient triggered breaths, achieved pressures and patient compliance. This study aimed to assess the potential impact of ventilator data downloads on management of patients requiring home non-invasive ventilation (NIV)...
2018: BMJ Open Respiratory Research
Mary M Mitchell, Eric D Hansen, Tuo-Yen Tseng, Meng Shen, Cynda Rushton, Tom Smith, Nancy Hutton, Jennifer Wolfe, Lee Bone, Jeanne Keruly, Lawrence Wissow, Amy R Knowlton
CONTEXT & OBJECTIVE: Advance care planning (ACP) rates remain low, especially among people who are HIV positive, disadvantaged, and African American. While ACP can be a sensitive topic for clinicians and patients to discuss, health values clarification can be an important initial step. METHODS: Data were from the first 325 participants in the AFFIRM Care study, which enrolled adults living with HIV/AIDS in Baltimore, MD, who had histories of illicit drug use...
March 8, 2018: Journal of Pain and Symptom Management
Rambod Amirnovin, Sara Aghamohammadi, Carley Riley, Marlyn S Woo, Sylvia Del Castillo
BACKGROUND: The population of children requiring home mechanical ventilation has evolved over the years and has grown to include a variety of diagnoses and needs that have led to changes in the care of this unique population. The purpose of this study was to provide a descriptive analysis of pediatric patients requiring home mechanical ventilation after hospitalization and how the evolution of this technology has impacted their care. METHODS: A retrospective, observational, longitudinal analysis of 164 children enrolled in a university-affiliated home mechanical ventilation program over 26 years was performed...
March 6, 2018: Respiratory Care
Nicolino Ambrosino, Michele Vitacca
Background: Progress in management has improved hospital mortality of patients admitted to the intensive care units, but also the prevalence of those patients needing weaning from prolonged mechanical ventilation, and of ventilator assisted individuals. The result is a number of difficult clinical and organizational problems for patients, caregivers and health services, as well as high human and financial resources consumption, despite poor long-term outcomes. An effort should be made to improve the management of these patients...
2018: Multidisciplinary Respiratory Medicine
Raúl Hidalgo Carvajal, Marcelino Sánchez Casado, Javier de Miguel-Díez, Encarnación López Gabaldón
INTRODUCTION AND OBJECTIVE: The effectiveness of home non-invasive mechanical ventilation (NIMV) is assessed by determining blood gas values in wakefulness, the evolution of their symptoms, and the monitoring of ventilation at night. The aim of our study is to evaluate whether defined values reached with outpatient monitoring by oximetry is related to the clinical, arterial gases and survival of a sample of patients with home NIMV. MATERIAL AND METHOD: Retrospective observational cohort study of a series of patients receiving home NIMV treatment for different causes...
February 28, 2018: Medicina Clínica
Craig M Dale, Judy King, Reshma Amin, Sherri Katz, Douglas McKim, Jeremy Road, Louise Rose
Purpose: No studies have explored the experiences of Canadian mechanical ventilator-assisted adolescents (VAAs) living at home as they transition from paediatric to adult health providers. A better understanding of the needs of this growing population is essential to provide transition services responsive to VAAs and caregiver-identified needs. Methods: We conducted semistructured telephone interviews with adolescents and family caregivers who had recently initiated or completed transition to adult care recruited from three Canadian university-affiliated paediatric home ventilation programs...
August 2017: Paediatrics & Child Health
Eliezer Be'eri, Simon Owen, Maurit Beeri, Scott R Millis, Arik Eisenkraft
OBJECTIVES: Chemical-biological-radio-nuclear (CBRN) gas masks are the standard means for protecting the general population from inhalation of toxic industrial compounds (TICs), for example after industrial accidents or terrorist attacks. However, such gas masks would not protect patients on home mechanical ventilation, as ventilator airflow would bypass the CBRN filter. We therefore evaluated in vivo the safety of adding a standard-issue CBRN filter to the air-outflow port of a home ventilator, as a method for providing TIC protection to such patients...
February 21, 2018: Disaster Medicine and Public Health Preparedness
Tomoaki Yatabe, Atsushi Nishigaki, Takahiko Tamura, Masataka Yokoyama
Background: Because there is ongoing population aging, the age of patients admitted to the intensive care unit (ICU) is also higher. However, the evidence about outcomes in elderly patients is insufficient in Japan. Therefore, we conducted a retrospective study. Method: The study participants were consecutive patients who were admitted to our ICU and received mechanical ventilation for more than 24 h. We divided the patients into two groups, according to age. Patients in group A were 74 years old or younger, and those in group B were 75 years old or older...
2018: JA Clin Rep
Martina Radner, Annette Henry
We report about an infant who was diagnosed with spinal muscular atrophy type 1 (Werdnig-Hoffmann) at the age of 7 weeks. In a detailed discussion with the physicians the parents decided against mechanical ventilation in the event of either acute or chronical respiratory failure. During care at home all palliative actions were taken to optimize the quality of life for the child. The boy died at the age of 7 months at home. Whether continuous mechanical ventilation in a child with spinal muscular atrophy type 1 should be the individual decision of the parents or whether it should never be offered by the physicians is discussed controversially in the present medical literature...
February 15, 2018: Wiener Medizinische Wochenschrift
Geak Poh Tan, Nigel McArdle, Satvinder Singh Dhaliwal, Jane Douglas, Clare Siobhan Rea, Bhajan Singh
Home mechanical ventilation (HMV) is used in a wide range of disorders associated with chronic hypoventilation. We describe the patterns of use, survival and predictors of death in Western Australia. We identified 240 consecutive patients (60% male; mean age 58 years and body mass index 31 kg m-2) referred for HMV between 2005 and 2010. The patients were grouped into four categories: motor neurone disorders (MND; 39%), pulmonary disease (PULM; 25%, mainly chronic obstructive pulmonary disease), non-MND neuromuscular and chest wall disorders (NMCW; 21%) and the obesity hypoventilation syndrome (OHS; 15%)...
January 1, 2018: Chronic Respiratory Disease
Enrico Cetrano, Matteo Trezzi, Aurelio Secinaro, Luca Di Chiara, Marilena Trozzi, Sergio Bottero, Angelo Polito, Adriano Carotti
BACKGROUND: The purpose of this study was to identify predictors of postoperative respiratory failure after surgical tracheoplasty for congenital tracheal stenosis. METHODS: Between February 2011 and April 2017, 16 infants underwent congenital tracheal stenosis repair. Preoperative computed tomography evaluation of the trachea and mainstem bronchi was performed. The primary outcome was midterm freedom from postoperative respiratory failure defined as persistent need for mechanical ventilation or surgical tracheobronchial reoperation...
February 1, 2018: Annals of Thoracic Surgery
Fyeza Hasan, Kevin Weingarten, Adam Rapoport, Eric Bouffet, Ute Bartels
The end-of-life management of children with diffuse intrinsic pontine glioma (DIPG) is challenging. Families cope with debilitating symptoms and make complex decisions regarding their child's care. However, there is little evidence guiding palliative care provision for these children. Our objective was to describe the dying trajectory of children with DIPG, their symptoms, the care they require and the end-of-life decisions made for them. This retrospective cohort study analyzed the end-of-life care of 41 consecutive patients with DIPG who died between January 2001 and June 2010...
February 3, 2018: Journal of Neuro-oncology
Mika L Nonoyama, Douglas A McKim, Jeremy Road, Denise Guerriere, Peter C Coyte, Marina Wasilewski, Monica Avendano, Sherri L Katz, Reshma Amin, Roger Goldstein, Brandon Zagorski, Louise Rose
BACKGROUND: Individuals using home mechanical ventilation (HMV) frequently choose to live at home for quality of life, despite financial burden. Previous studies of healthcare utilisation and costs do not consider public and private expenditures, including caregiver time. OBJECTIVES: To determine public and private healthcare utilisation and costs for HMV users living at home in two Canadian provinces, and examine factors associated with higher costs. METHODS: Longitudinal, prospective observational cost analysis study (April 2012 to August 2015) collecting data on public and private (out-of-pocket, third-party insurance, caregiving) costs every 2 weeks for 6 months using the Ambulatory and Home Care Record...
January 26, 2018: Thorax
Kathryn Cappell, Vandana Sundaram, Annie Park, Parveen Shiraz, Ridhi Gupta, Patricia Jenkins, Vyjeyanthi S J Periyakoil, Lori Muffly
Background Allogeneic hematopoietic cell transplantation (HCT) is associated with significant morbidity and mortality, making advance care planning (ACP) and management especially important in this patient population. A paucity of data exists on the utilization of ACP amongst allogeneic HCT recipients, and the relationship between ACP and intensity of health care utilization in these patients. Methods We performed a retrospective review of patients receiving allogeneic HCT at our institution from 2008 to 2015 who had subsequently died following HCT...
January 22, 2018: Biology of Blood and Marrow Transplantation
Bertrand Herer
BACKGROUND: The incidence of chronically ill subjects with prolonged mechanical ventilation (PMV) has significantly increased over the last decade because of improvements in acute critical care. The aim of this study was to describe the outcomes and care pathways of subjects receiving PMV through a tracheostomy tube in an intermediate-care facility. METHODS: Sixty-six subjects with chronic respiratory failure who experienced 109 hospitalizations between December 2010 and December 2012 in a 34-bed post-care unit were retrospectively included and followed for at least 1 y...
January 23, 2018: Respiratory Care
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