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domiciliary ventilation

F Rusalen, C Agosto, L Brugnaro, F Benini
In the last 20 years, the prevalence of children on domiciliary long-term ventilation (LTV) has increased in many countries and in Italy it is now 4.3/100,000 (1). The complex management of these patients' conditions requires highly specialised expertise that is provided by integrated multi-disciplinary teams and calls for solutions from a number of institutional agencies (2). The global care offered to these patients by paediatric palliative care (PPC) also embraces their social needs (3-4). This article is protected by copyright...
January 30, 2017: Acta Paediatrica
P Gouda, J Chua, D Langan, T Hannon, A Scott, A O'Regan
BACKGROUND: While domiciliary non-invasive ventilation (NIV) was initially used in the treatment of respiratory failure resulting from chest wall deformity, the main indication is now chronic obstructive pulmonary disease (COPD) with recurrent exacerbations associated with type 2 respiratory failure. A longitudinal study of domiciliary NIV provides insights into the evolution of this treatment in the west of Ireland. METHODS: The cohort of patients receiving new prescriptions for domiciliary NIV from Galway University Hospital from 2000 to 2012 was reviewed using study coordinator chart reviews and telephone follow-ups...
October 15, 2016: Irish Journal of Medical Science
Janine Dretzke, David Moore, Chirag Dave, Rahul Mukherjee, Malcolm J Price, Sue Bayliss, Xiaoying Wu, Rachel E Jordan, Alice M Turner
INTRODUCTION: Noninvasive ventilation (NIV) improves survival among patients with hypercapnic respiratory failure in hospital, but evidence for its use in domiciliary settings is limited. A patient's underlying risk of having an exacerbation may affect any potential benefit that can be gained from domiciliary NIV. This is the first comprehensive systematic review to stratify patients based on a proxy for exacerbation risk: patients in a stable state and those immediately post-exacerbation hospitalization...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Hilal Altinoz, Nalan Adiguzel, Cuneyt Salturk, Gokay Gungor, Ozlem Mocin, Huriye Berk Takir, Feyza Kargin, Merih Balci, Oner Dikensoy, Zuhal Karakurt
Cachexia is known to be a deteriorating factor for survival of patients with chronic obstructive pulmonary disease (COPD), but data related to obesity are limited. We observed that obese patients with COPD prescribed long-term noninvasive mechanical ventilation (NIMV) had better survival rate compared to nonobese patients. Therefore, we conducted a retrospective observational cohort study. Archives of Thoracic Diseases Training Hospital were sought between 2008 and 2013. All the subjects were prescribed domiciliary NIMV for chronic respiratory failure secondary to COPD...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Robin S Howard
PURPOSE OF REVIEW: Understanding the mechanisms and abnormalities of respiratory function in neuromuscular disease is critical to supporting the patient and maintaining ventilation in the face of acute or chronic progressive impairment. RECENT FINDINGS: Retrospective clinical studies reviewing the care of patients with Guillain-Barré syndrome and myasthenia have shown a disturbingly high mortality following step-down from intensive care. This implies high dependency and rehabilitation management is failing despite evidence that delayed improvement can occur with long-term care...
October 2016: Current Opinion in Neurology
Cristóbal Esteban, Susana Garcia-Gutierrez, Maria J Legarreta, Ane Anton-Ladislao, Nerea Gonzalez, Iratxe Lafuente, Nerea Fernandez de Larrea, Silvia Vidal, Marisa Bare, José M Quintana, Iryss -Copd Group
Mortality is one of the most important outcomes in patients with chronic obstructive pulmonary disease (COPD). Different predictors have been associated with mortality, including the patient's level of physical activity (PA). The objective of this work was to establish the relationship between changes in PA during a moderate-to-severe COPD exacerbation (eCOPD) and 1-year mortality after the index event. This was a prospective observational cohort study with recruitment of 2,484 patients with an eCOPD attending the emergency department (ED) of 16 participating hospitals...
December 2016: COPD
Aylin Özsancak Uğurlu, Huriye Berk Takır, Begüm Ergan, Erdal İn, Ezgi Özyilmaz, Özlem Ertan Edipoğlu, Eylem Acartürk, Ege Güleç Balbay, Aslı Görek Dilektaşlı, Tülay Kıvanç, Pervin Korkmaz Ekren, Sevinç Sarınç Ulaşlı, Ilgaz Doğrul, Elif Yılmazel Uçar, Şehnaz Olgun, Özkan Devran, Recai Ergun, Zuhal Karakurt
INTRODUCTION: To define approach of pulmonologists in Turkey to noninvasive mechanical ventilation (NIV) use for chronic respiratory failure (CRF), the most currently applied technique for home mechanical ventilation. PATIENTS AND METHODS: A 38-question survey, developed and tested by the authors, was distributed throughout Turkey to 2205 pulmonologists by e-mail. RESULT: Twenty-seven percent of the pulmonologists responded (n=596). Domiciliary NIV was reported to be prescribed by 340 physicians [57...
March 2016: Tüberküloz Ve Toraks
Adrien Tissot, Sandrine Jaffre, Frédéric Gagnadoux, Marc Levaillant, Frédéric Corne, Sylvaine Chollet, François-Xavier Blanc, François Goupil, Pascaline Priou, Wojciech Trzepizur, Antoine Magnan
BACKGROUND: Home non-invasive ventilation (NIV) is a widely used treatment for chronic hypoventilation but little is known on its impact in the elderly. In a multicenter prospective cohort study, we studied tolerance and efficacy of domiciliary NIV in patients aged 75 or more compared to younger ones. METHODS AND RESULTS: 264 patients with at least a six-month follow-up were analyzed. Among them, 82 were elderly. In the elderly and the younger, we found an improvement of arterial blood gas, the Epworth sleepiness scale and the Pittsburgh sleep quality index at 6 months...
2015: PloS One
Janine Dretzke, Deirdre Blissett, Chirag Dave, Rahul Mukherjee, Malcolm Price, Sue Bayliss, Xiaoying Wu, Rachel Jordan, Sue Jowett, Alice M Turner, David Moore
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a chronic progressive lung disease characterised by non-reversible airflow obstruction. Exacerbations are a key cause of morbidity and mortality and place a considerable burden on health-care systems. While there is evidence that patients benefit from non-invasive ventilation (NIV) in hospital during an acute exacerbation, evidence supporting home use for more stable COPD patients is limited. In the U.K., domiciliary NIV is considered on health economic grounds in patients after three hospital admissions for acute hypercapnic respiratory failure...
October 2015: Health Technology Assessment: HTA
D M Comer, A Oakes, R Mukherjee
AIM: To determine if the long terms effects of non-invasive home mechanical ventilation (NIHMV) in the elderly are as beneficial as in younger subjects for a dedicated non-invasive ventilation unit in a tertiary referral hospital within the UK. PATIENTS AND METHODS: The study population included 256 patients who were successfully established on NIHMV between May 2009 and August 2013. Patients were divided into three groups according to age: group 1 (n=103) ≥75; group 2 (n=81) 65 -74; and group 3 (n=72) < 65 years of age...
January 2015: Ulster Medical Journal
Michelle Chatwin, Hui-Leng Tan, Andrew Bush, Mark Rosenthal, Anita Kay Simonds
BACKGROUND: The number of children receiving domiciliary ventilatory support has grown over the last few decades driven largely by the introduction and widening applications of non-invasive ventilation. Ventilatory support may be used with the intention of increasing survival, or to facilitate discharge home and/or to palliate symptoms. However, the outcome of this intervention and the number of children transitioning to adult care as a consequence of longer survival is not yet clear...
2015: PloS One
A Walsh, F Phelan, M Phelan, M Ryan, F Healy, D M Slattery, B Elnazir, P Greally, B Linnane, M Ní Chróinín, D Mullane, M Herzig, D W Cox, S Javadpour, P McNally
Sleep related breathing disorders (SRBD) have historically been under-recognised and under-treated. Obstructive sleep apnoea (OSA) affects approximately 3% of children. In line with the increased recognition of SRBD there has been an increase in demand for diagnostic services. We determined the awareness of SRBD amongst Irish paediatricians, examined the provision of sleep services to children throughout the country between 2007 and 2011 and audited diagnostic sleep services in a tertiary centre in 2011. Amongst respondents there was an awareness of SRBD but a poor understanding of diagnostic evaluation with 31/46 (67) referring to inappropriate services...
March 2015: Irish Medical Journal
M P Arellano Maric, R Roldán Toledo, S E Huttmann, J H Storre, W Windisch
Home mechanical ventilation is currently expanding in Chile, but its application along the country is hindered by financial and geographical reasons. In 2006 the San José Hospital in Santiago de Chile developed a non-invasive ventilation (NIV) center as a strategy to overcome the limitations of ventilator availability from public resources. Since then, this center provides intermittent diurnal sessions of NIV to patients with chronic hypercapnic respiratory failure. In 2013, a collaboratory work between the Chilean doctors, the German Interdisciplinary Society of Home Mechanical Ventilation (DIGAB = Deutsche Interdisziplinäre Gesellschaft für Außerklinische Beatmung) and the German non-invasive (NIV) home care provider "Heinen und Löwenstein" organized a donation of 100 second-hand ventilators (BiPAP Synchrony; Respironics, USA) including masks and tubing systems, which were provided by Heinen und Löwenstein...
March 2015: Pneumologie
Nicola K Gale, Maryam Jawad, Chirag Dave, Alice M Turner
BACKGROUND: Domiciliary non-invasive ventilation may be used in palliative care of patients with chronic obstructive pulmonary disease, although there is uncertainty regarding effect on quality of life. AIM: Explore experiences of domiciliary non-invasive ventilation in chronic obstructive pulmonary disease, to understand decision-making processes and improve future palliative care. DESIGN: Qualitative interview study, based on constructivist grounded theory, and using the framework method for data management and analysis...
March 2015: Palliative Medicine
Nicholas S Oscroft, Rebecca Chadwick, Michael G Davies, Timothy G Quinnell, Ian E Smith
BACKGROUND: The addition of domiciliary non-invasive ventilation (NIV) to standard therapy in chronic obstructive pulmonary disease (COPD) patients with compensated ventilatory failure (CVF) is reported to have beneficial effects. Compliance with NIV is an important factor. Volume assured NIV (va-NIV) may improve compliance and ventilation during sleep by automatically titrating ventilatory pressures. METHODS: A prospective single centre, randomised, parallel group trial comparing va-NIV and pressure preset NIV (pp-NIV) in COPD patients with CVF naïve to domiciliary NIV was performed (ISCRTN91892415)...
October 2014: Respiratory Medicine
Emilia Biffi, Caterina Piazza, Matteo Cavalleri, Peter Taddeo, Alessandro Carcano, Francesco Morandi, Gianluigi Reni
Congenital Central Hypoventilation Syndrome is a genetic disease characterized by alveolar hypoventilation and autonomic dysregulation. Patients have hypoventilations, especially during sleep, conditioning hypercapnia which can lead to neurological damage and death. They therefore need mechanical ventilators, that provide sufficient gas exchange, and pulse-oximeters that monitor oxy-hemoglobin blood concentration. Due to the restrictions regarding domiciliary assistive devices, the presence of a caregiver is required all night long...
October 2014: Annals of Biomedical Engineering
Nicolás González Mangado, María Fernanda Troncoso Acevedo, Teresa Gómez García
Obstructive sleep apnea-hypopnea is a highly prevalent disease that is often underdiagnosed at present. It has a significant economic and social welfare impact, accounting for a large part of the resources assigned to home respiratory therapies. As part of the 2014 SEPAR Year of the Chronic Patient and Domiciliary Respiratory Care sponsored by the Spanish Society of Pulmonology and Thoracic Surgery, this article reviews the most recent publications on the indications and controversial issues in the treatment of sleep apnea, the latest evidence for indication of various positive pressure devices, and adjustment modes, ranging from the use of empirical formulae or mathematical estimations to modern auto-CPAP equipment, while not forgetting the gold standard of manual titration...
December 2014: Archivos de Bronconeumología
Alex H Gifford
PURPOSE OF REVIEW: Dyspnea is a distressing consequence of many unremitting diseases. This review discusses the therapeutic use of noninvasive ventilation (NIV) in advanced illness. RECENT FINDINGS: NIV continues to be investigated most rigorously in patients with progressive neuromuscular weakness and the combination of emphysema and lung cancer. Data are quite limited on the palliative role of NIV in bronchiectasis and interstitial lung diseases. It remains difficult to identify the subsets of patients with acute-on-chronic respiratory failure who are most likely to benefit from ICU admission, but NIV may particularly help those with hypercapnia...
September 2014: Current Opinion in Supportive and Palliative Care
B Schönhofer
BACKGROUND: Chronic respiratory failure is caused by insufficiency of the inspiratory muscles, i.e. mainly the diaphragm, which represents the so-called "respiratory pump". Insufficiency of the respiratory pump causes hypercapnia. THERAPEUTIC INTERVENTION: Diseases with chronic hypercapnia are characterized by reduced survival. Mechanical ventilation-mostly applied as noninvasive mechanical ventilation (NIV)-improves ventilation and unloads the inspiratory muscles...
April 2015: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Kazuya Tone, Ikumi Kiryu, Masahiro Yoshida, Kazuto Tsuboi, Masamichi Takagi, Kazuyoshi Kuwano
An elderly woman diagnosed with multiple myeloma (MM) in 2007 had improved with chemotherapy. She had severe kyphosis and a diaphragmatic hernia (DH), but no respiratory symptoms. In 2011, because of thoracic deformity and emaciation, we advised her to continue the previously prescribed domiciliary noninvasive positive pressure ventilation (NPPV) therapy for chronic type II respiratory failure. However, she refused to continue NPPV. She was later admitted for deterioration in respiratory status and carbon dioxide (CO2) narcosis...
May 2014: Respiratory Investigation
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