Home ventilation: Table 1—

Abstract

Home ventilation is a growth area. Rapid expansion during the 1990s was stimulated by the development of noninvasive ventilation (NIV)viaa mask and the recognition that an increased number of patient groups can benefit. Although patients receiving NIV in the home outnumber those receiving invasive ventilationviatracheostomy, there is substantial variation in practice between European countries.Evidence that individuals who develop ventilatory failure as a consequence of chest wall disease or stable neuromuscular disease such as old poliomyelitis benefit from nocturnal NIV is overwhelming. Patients with progressive neuromuscular disease such as Duchenne muscular dystrophy and amyotrophic lateral sclerosis can also derive prolongation of life, palliation of symptoms and an improvement in quality of life.Home ventilation in chronic obstructive pulmonary disease (COPD) patients remains controversial. Multicentric randomised controlled trials of long-term oxygen therapy (LTOT)versusNIV plus LTOT in COPD have produced mixed results, although certain subgroups,e.g.those with recurrent infective exacerbations requiring short-term NIV, patients aged >65 yrs, and those with uncontrolled hypercapnia on LTOT or symptomatic nocturnal hypoventilation, may benefit.At the other end of the age spectrum, children as young as a few months can be successfully treated with noninvasive ventilation. Most work on paediatric home ventilation centres on children with congenital neuromuscular disease. Pressure preset bilevel ventilators are now the dominant form of ventilator in adults and children. Discharge planning is vital for the home ventilator patient and a sensible risk management strategy should be in place.

Clinical Evaluation of Invasive Home Mechanical Ventilation Dependent Pediatric Patients

“…It has been proved since 1970s that these devices can be used at home for medically stable patients suffering from chronic respiratory failure (5). HMV allows patients to go home and grow and develop in their natural environment (6). In the past two decades, more and more patients with chronic respiratory failure have been treated with HMV (7).…”

Noninvasive Monitoring of Breathing and Swallowing Interaction

“…Moreover, improvements in the management of chronic respiratory failure translate into differences in breathing conditions across patients and over time, and this variability is likely to complicate the evaluation of breathing-swallowing interactions. These breathing conditions are now well defined and include spontaneous breathing (SB), (Raphael, Chevret et al 1994), noninvasive mechanical ventilation (NIV) (Bach, Alba et al 1993;Mehta and Hill 2001 (Bach and Alba 1990;Chadda, Louis et al 2002), and tracheostomy with MV (Bach and Alba 1990;Bach 1993;Simonds 2003). In contrast to spontaneously breathing patients, tracheostomized patients receiving assistcontrol MV cannot prolong their expiratory phase.…”

Guidelines for Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure

“…NIV is the primary treatment option for restrictive thoracic disease patients with CRF [8, 53 -55]. This generally encompasses the following conditions [9,56]: " Scoliosis " Kyphosis " Pectus carinatum (pigeon chest)…”