Data Downloads for Effective Noninvasive Ventilation in Patients With Neuromuscular Respiratory Failure

Sandoz, Jac queline S; LeBlanc, Carole; McKim, Douglas

doi:10.4187/respcare.02153

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…In addition, they would be able to support the detailed interrogation of the data download from the ventilator, which can provide information on adherence, leak, tidal volume and breathing pattern. This information can help optimise treatment at clinic reviews [49,50], and going forward, will allow remote assessment of ventilation efficacy [51].…”

Section: Ventilationmentioning

confidence: 99%

The adult multidisciplinary respiratory neuromuscular clinic

Shah

Murphy

Kaltsakas

2020

Breathe

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Many neuromuscular disorders (NMD) are complicated by respiratory failure. These patients are best managed in a multidisciplinary outpatient clinic to provide timely access to the various disciplines they require. The key mainstay of treatment of respiratory failure in patients with NMD is noninvasive ventilation, supported by secretion clearance, speech and language therapy, optimisation of nutrition and the maintenance of mobility. Patients with specific conditions may also require cardiology, neurology, orthopaedics, urology and psychological services. The respiratory NMD multidisciplinary team should also provide access to palliative care, and caregiver health and wellbeing should also be reviewed at clinical reviews. The future of care for the respiratory NMD patient will increasingly involve home services and telehealth and the clinic should be equipped and resourced to deliver these. Although not all health systems will be able to provide all elements of the multidisciplinary team discussed here, this review provides the “ideal” recipe for the adult multidisciplinary team and the evidence base underpinning this from which a clinic can be developed.Educational aimsTo provide an overview of the care of an adult neuromuscular disorder patient presenting to the multidisciplinary respiratory clinic.To provide the evidence base for establishing the different elements of the multidisciplinary respiratory clinic.

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Section: Ventilationmentioning

confidence: 99%

The adult multidisciplinary respiratory neuromuscular clinic

Shah

Murphy

Kaltsakas

2020

Breathe

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“…27,28 Nocturnal bi-level parameters were determined in the out-patient clinic. Subsequent adjustments were made based on comfort, symptoms, downloaded bi-level data, 29 carbon dioxide level, and overnight oximetry.…”

Section: Study Populationmentioning

confidence: 99%

Daytime Mouthpiece for Continuous Noninvasive Ventilation in Individuals With Amyotrophic Lateral Sclerosis

Bédard

McKim

2016

Respir Care

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“…Others have suggested that ventilator-derived data could be used to guide alterations to ventilator settings to optimise therapy. 2 It is also possible that a change in ventilator-derived indices observed using remote monitoring could identify a deteriorating patient or a malfunctioning device, thus allowing for earlier clinical intervention.…”

Section: Introductionmentioning

confidence: 99%

Typical within and between person variability in non-invasive ventilator derived variables among clinically stable, long-term users

et al. 2021

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BackgroundDespite increasing capacity to remotely monitor non-invasive ventilation (NIV), how remote data varies from day to day and person to person is poorly described.MethodsSingle-centre, 2-month, prospective study of clinically stable adults on long-term NIV which aimed to document NIV-device variability. Participants were switched to a ventilator with tele-monitoring capabilities. Ventilation settings and masking were not altered. Raw, extensible markup language data files were provided directly from Philips Respironics (EncoreAnywhere). A nested analysis of variance was conducted on each ventilator variable to apportion the relative variation between and within participants.ResultsTwenty-nine people were recruited (four withdrew, one had insufficient data for analyses; 1364 days of data). Mean age was 54.0 years (SD 18.4), 58.3% male with body mass index of 37.0 kg/m2 (13.7). Mean adherence was 8.53 (2.23) hours/day and all participants had adherence >4 hours/day. Variance in ventilator-derived indices was predominantly driven by differences between participants; usage (61% between vs 39% within), Apnoea–Hypopnoea Index (71% vs 29%), unintentional (64% vs 36%) and total leak (83% vs 17%), tidal volume (93% vs 7%), minute ventilation (92% vs 8%), respiratory rate (92% vs 8%) and percentage of triggered breaths (93% vs 7%).InterpretationIn this clinically stable cohort, all device-derived indices were more varied between users than the day-to-day variation within individuals. We speculate that normative ranges and thresholds for clinical intervention need to be individualised, and further research is necessary to determine the clinically important relationships between clinician targets for therapy and patient-reported outcomes.

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Data Downloads for Effective Noninvasive Ventilation in Patients With Neuromuscular Respiratory Failure

Cited by 5 publications

References 24 publications

The adult multidisciplinary respiratory neuromuscular clinic

The adult multidisciplinary respiratory neuromuscular clinic

Daytime Mouthpiece for Continuous Noninvasive Ventilation in Individuals With Amyotrophic Lateral Sclerosis

Typical within and between person variability in non-invasive ventilator derived variables among clinically stable, long-term users

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