Time-to-death in chronic respiratory failure on home mechanical ventilation: A cohort study

Schwarz, Esther I.; Mackie, Mike; Weston, Nick; Tincknell, Laura; Beghal, G; Cheng, Michael; Ramsay, Michelle; Suh, Eui‐Sik; Kaltsakas, Georgios; Pattani, Hina; Marino, Philip; Murphy, Patrick B.; Hart, Nicholas; Steier, Joerg

doi:10.1016/j.rmed.2020.105877

Cited by 26 publications

(31 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a European survey, patients treated with TPPV represented 13% of the population on long-term mechanical ventilation [82], with a wide variability from country to country. In a British study of all-cause mortality of 1,210 patients under HMV over a 10-year period, patients using TPPV represented 12% of the deceased [214]. A similar proportion of TPPV in HMV has been reported in Canada [215].…”

Section: Special Situationsmentioning

confidence: 74%

“…TPPV is associated with the risk of specific complications such as life-threatening – although rare – tracheal bleeding, ventilator-associated pneumonia, obstructive mucus plugging or tracheal granuloma formation and stenosis that may increase morbidity and mortality compared to NIV [224-226]. Data on outcomes of long-term tracheostomy ventilation come from cohort studies but have not been systematically analyzed and compared to NIV in a conclusive way [214, 215, 227, 228].…”

Section: Special Situationsmentioning

confidence: 99%

“…Different settings for day- and night-time may be used. Pressure-controlled ventilation (PCV) or volume controlled ventilation are more commonly used than PSV in TPPV [214]. A target-volume might be set in addition to pressure modes, but advantages of this have not been demonstrated so far.…”

Section: Special Situationsmentioning

confidence: 99%

See 2 more Smart Citations

Long-Term Mechanical Ventilation: Recommendations of the Swiss Society of Pulmonology

et al. 2020

View full text Add to dashboard Cite

Long-term mechanical ventilation is a well-established treatment for chronic hypercapnic respiratory failure (CHRF). It is aimed at improving CHRF-related symptoms, health-related quality of life, survival, and decreasing hospital admissions. In Switzerland, long-term mechanical ventilation has been increasingly used since the 1980s in hospital and home care settings. Over the years, its application has considerably expanded with accumulating evidence of beneficial effects in a broad range of conditions associated with CHRF. Most frequent indications for long-term mechanical ventilation are chronic obstructive pulmonary disease, obesity hypoventilation syndrome, neuromuscular and chest wall diseases. In the current consensus document, the Special Interest Group of the Swiss Society of Pulmonology reviews the most recent scientific literature on long-term mechanical ventilation and provides recommendations adapted to the particular setting of the Swiss healthcare system with a focus on the practice of non-invasive and invasive home ventilation in adults.

show abstract

Section: Special Situationsmentioning

confidence: 74%

Section: Special Situationsmentioning

confidence: 99%

See 1 more Smart Citation

Long-Term Mechanical Ventilation: Recommendations of the Swiss Society of Pulmonology

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In the series analyzed (table 4) the percentage of patients invasively ventilated through tracheostomy (TIV) varies between 3.1% and 12.4% (25,23,8,26) whereas in our cohort it was only 5.24%, this difference may be a consequence of the fact that in the Canadian program the most frequent diagnosis was NMD (30.4%) while the English cohort reported that it had 21.6% of patients with a diagnosis of ALS (26).…”

Section: Discussionmentioning

confidence: 52%

“…In 2020, Schwarz et al analyzed the time elapsed from admission to death of 1,210 patients on HMV in England and described that patients with ALS had the lowest mean survival, of 7 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) months, whereas patients with OHS on HMV had the longest survival, 33 (13-75) months, and the mean survival of the overall cohort was 19.5 months; in addition, 150 patients (12.4%) were ventilated through tracheostomy (26). The Swedish group describes that of its 1526 patients, only 6% were ventilated through tracheostomy and that the worst survival was observed in patients with ALS, with 20% survival at 2 years and 5% at 5 years (25).…”

Section: Discussionmentioning

confidence: 99%

Home Mechanical Ventilation: Results of A National Program In Adults (2008 to 2017), Ministry of Health, Chile

Maquilón

Antolini²,

Valdés

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Home mechanical ventilation (HMV) is a viable and effective strategy for patients with chronic respiratory failure (CRF) of different causes. The Chilean Ministry of Health started in 2006 a program for HMV in Children and in 2008 it began a program for HMV in adults. All belonged to the state health insurance.Methods: Prospective cohort of adult patients with CRF in 10 regions of Chile admitted to the national HMV program, their demographic, clinical and functional characteristics, mode of admission, time in the program and survival.Results: A total of 1,105 patients were included. Median age was 59 years (44-58, IQR1-IQR3). Women were 58.1%. The body mass index was 34.9 (26-46) kg/m2, and 942 (85.4%) belonged to low-income socioeconomic groups. The baseline score on the Severe Respiratory Insufficiency questionnaire (SRI) was 47 (35-62.1) points, 98.5% lived in urban areas, 76.2% initiated HMV in the stable chronic mode, 23.8% in the acute mode and 99 patients were transferred from the children's program. There were 1047 patients on noninvasive ventilation and 58 on invasive ventilation through tracheostomy. Baseline PaCO2 was 58.2 (52-65) mmHg. Device usage time was 7.3 h/d (5.8-8.8), the time in HMV was 21.6 (12.2-49.5) months. The diagnostic groups were COPD, 35%; obesity hypoventilation syndrome (OHS), 23.9%; neuromuscular disease (NMD) 16.3%; non-cystic fibrosis bronchiectasis or tuberculosis (non-CF BC or TBC) 8.3%; Scoliosis, 5.9%; and Amyotrophic Lateral Sclerosis (ALS) 5.24%. The lowest 1- and 3-year survival rates were observed in the ALS group, i.e., 67% and 26%, respectively, and the lowest 9-year survival was observed in the non-CF BC or TB and COPD, 27% and 30.9%, respectively. The best survival rates at 9 years were 57.7%, 57.2% and 50.9% for patients with OHS, Scoliosis and NMD, respectively.Conclusion: The most common diagnoses were COPD and OHS. Patients were hypercapnic and had poor quality of life at program admission. The best survival was observed in patients with OHS, Scoliosis and NMD.

show abstract

Health Communication and Adherence to Noninvasive Ventilation in Chronic Hypercapnic Respiratory Failure

Yu,

Li,

Lau

et al. 2024

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceDomiciliary noninvasive ventilation (NIV) is a standard treatment for improving health outcomes among patients with chronic hypercapnic respiratory failure (CHRF). However, poor adherence substantially limits its therapeutic effectiveness.ObjectiveTo determine the effect of an information-motivation-behavioral (IMB) skills-based intervention (IMB-NIV program) on NIV adherence, patient-reported health outcomes, and health service use among patients with CHRF.Design, Setting, and ParticipantsThis multisite, assessor-blinded, randomized clinical trial was conducted from January 2022 to March 2023 at respiratory clinics of 2 regional hospitals in Hong Kong among patients with CHRF who had been nonadherent to prescribed domiciliary NIV.InterventionsThe 6-week IMB-NIV program used a hybrid approach, combining in-person and telecare sessions, to provide patients with knowledge, skills, a positive attitude, and social motivation to enhance NIV adherence.Main Outcomes and MeasuresThe primary outcome was NIV adherence data retrieved from the NIV machine. Secondary outcomes included the Pittsburgh Sleep Quality Index, Chinese Severe Respiratory Insufficiency questionnaire, venous bicarbonate (HCO3−) level, emergency department (ED) and hospital admissions, and mortality measured at baseline, program completion, and 3, 6, and 12 months.ResultsOf the 124 participants (mean [SD] age, 73.7 [7.2] years; 67 [54.0%] female), the 62 patients in the IMB-NIV group were more likely to adhere to NIV compared with the 62 patients in the usual care group at 12 months (61.3% vs 27.4%; odds ratio, 2.78; 95% CI, 1.69 to 4.55), with a greater increase noted in daily NIV use in hours at that time (B = 2.37; 95% CI, 1.44 to 3.31). A generalized estimating equation indicated significantly greater improvements in sleep quality (B = −3.63; 95% CI, −5.14 to −2.12) and health-related quality of life (β = 14.84; 95% CI, 9.18 to 20.49) at 12 months in the IMB-NIV group. The IMB-NIV group had significantly lower ED admissions (incidence rate ratio, 0.47; 95% CI, 0.26 to 0.84) and a longer time to the first ED visit (hazard ratio, 0.51; 95% CI, 0.28 to 0.95). No significant treatment effect was observed on venous HCO3− levels or hospital admissions.Conclusions and RelevanceIn this randomized clinical trial, the IMB-NIV program offered a promising behavioral approach to improve NIV adherence in patients with CHRF. Its sustained positive effects on sleep quality, health-related quality of life, and ED admissions highlight its potential to optimize the therapeutic benefits of NIV.Trial RegistrationClinicalTrials.gov Identifier: NCT05008211.

show abstract

Time-to-death in chronic respiratory failure on home mechanical ventilation: A cohort study

Cited by 26 publications

References 19 publications

Long-Term Mechanical Ventilation: Recommendations of the Swiss Society of Pulmonology

Long-Term Mechanical Ventilation: Recommendations of the Swiss Society of Pulmonology

Home Mechanical Ventilation: Results of A National Program In Adults (2008 to 2017), Ministry of Health, Chile

Health Communication and Adherence to Noninvasive Ventilation in Chronic Hypercapnic Respiratory Failure

Contact Info

Product

Resources

About