A progressive care programme for prolonged ventilatory failure: analysis of outcome

Smith, Ian; Shneerson, John M.

doi:10.1093/bja/75.4.399

Cited by 26 publications

(23 citation statements)

References 27 publications

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“…This was the case in both restrictive and obstructive disorders. The SF-36, a generic questionnaire, and the HAD have also been applied to patients with CRF and HMV in previous studies [26, 27, 28]. MRF-28 ‘total’ scores, subscores for ‘daily activity’, and ‘invalidity’ scores were correlated with all domains of the SF-36 and HAD questionnaires.…”

Section: Discussionmentioning

confidence: 99%

Validity and Reliability of a French Version of the MRF-28 Health-Related Quality of Life Questionnaire

et al. 2004

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Background: Evaluation of health-related quality of life (HRQL) in chronic respiratory failure (CRF) is an important issue for evaluating the impact of treatment. Objectives: To elaborate a French version of the Maugeri Foundation Respiratory Failure Questionnaire (MRF-28) disease-specific HRQL questionnaire and determine its validity and reliability in patients with CRF treated by home mechanical ventilation (HMV). Methods: Forward- and back-translation of the MRF-28 questionnaire; the final version was submitted to 81 patients treated with HMV for CRF, simultaneously with the St. George’s Respiratory Questionnaire (SGRQ), the Short Form 36 (SF-36), and the Hospital Anxiety and Depression scale (HAD). Validity was determined by correlation with previously validated HRQL scores and recorded physiological parameters. Reliability was evaluated by assessing internal consistency and test-retest stability of the MRF-28 scores. Results: The French version of the MRF-28 and its subscores (‘daily activity’, ‘cognitive function’, and ‘invalidity’) were highly significantly correlated with subscores of the SGRQ, the SF-36 and the HAD. Both the MRF-28 and the SGRQ were correlated only with age and the 6-min walk test. The MRF-28 showed high test-retest reliability after 2 weeks (r² = 0.80, p < 0.0001) and high internal consistency (Crohnbachs’ α coefficient: 0.91). Conclusion: The French version of the MRF-28 is a valid and reliable disease-specific questionnaire for assessing HRQL in patients with CRF.

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Section: Discussionmentioning

confidence: 99%

Validity and Reliability of a French Version of the MRF-28 Health-Related Quality of Life Questionnaire

et al. 2004

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“…Nasal ventilation has also been tried as an assistance in the weaning process of patients who require prolonged tracheostomy ventilation, but the results are inconclusive [36,37]. This is hardly surprising, since the ability to provide partial and intermittent ventilatory support, whilst important, is only one element in the overall programme of care that is required to overcome weaning difficulties [38].…”

Section: Acute Respiratory Failurementioning

confidence: 99%

The changing role of mechanical ventilation in COPD

Shneerson¹

1996

Eur Respir J

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For many years, mechanical ventilation has been employed in patients with chronic obstructive pulmonary disease (COPD) but the recent development of noninvasive techniques, particularly nasal and face mask ventilation, have considerably increased its use. The enthusiasm for these methods, however, has not been matched by the results from well-constructed studies, and the role of ventilatory support both in acute and chronic respiratory failure is still not settled. Acute respiratory failureThe steadily increasing number of publications on the use of noninvasive ventilation in acute infective exacerbations of COPD are hard to evaluate for several reasons. Firstly, most of the studies are uncontrolled or use historical or other unsatisfactory control groups. The definition of an infective exacerbation and its severity also varies considerably between the studies. Some studies compare the results of ventilation against "standard" medical treatment but this is frequently unspecified and, where details are given, oxygen appears to have been provided in flow rates sufficiently high to risk precipitating hypercapnia. Lastly, the criteria for the success or failure of noninvasive ventilation, such as the need for intubation, differ between studies.Series published before the use of noninvasive ventilation indicated that the intubation rate was around 25% for hospitalized COPD patients with an acute infective exacerbation [1,2]. Their survival to discharge from hospital was around 60-75%, and at 1 year was around 50% and 2 years around 35% [3-6]. The major areas of interest with noninvasive techniques have been to show whether they can adequately ventilate these patients, reduce the intubation rate and improve survival. Approximately 60-80% of patients tolerate both positive pressure ventilation by face or nasal mask [7,8] and negative pressure ventilation [9]. With mask ventilation, the arterial blood gases can usually be improved within 1-2 h, especially if the initial arterial carbon dioxide tension (Pa,CO 2 ) is raised [10][11][12][13][14][15][16], although in a controlled study there was no difference in the blood gases between the ventilated and nonventilated patients [17]. Early studies with negative pressure ventilation also showed that ventilation could be adequately supported [18][19][20][21][22], and these findings have been confirmed in subsequent uncontrolled studies [9,[23][24][25]. The mechanisms by which noninvasive ventilation achieves these effects have not been established.It can reduce respiratory muscle activity [26] and increase maximum inspiratory pressures [9, 24], but whether these or any changes in respiratory drive or mechanics are clinically significant is still uncertain.There are few data regarding the ability of negative pressure systems to avoid or delay intubation, but this question has been addressed in several reports of mask ventilation. Three series using historical controls suggested that the intubation rate could be reduced [27][28][29]. The results of a fourth are published in this ...

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“…SIMONDS and ELLIOTT [15] studied patients with hypercapnic CRF caused by either obstructive or restrictive diseases. SMITH and SHNEERSON [16] administered the SF-36 to a group of severe acute respiratory patients 1 yr after successful discharge from the intensive care unit. The scores were clearly different from those of healthy subjects, but formal tests of the discriminative properties of the SF-36 have not been performed in patients with respiratory failure.…”

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confidence: 99%

Sputum endothelin-1 is increased in cystic fibrosis and chronic obstructive pulmonary disease

Chalmers¹,

MacLeod²,

Sriram

et al. 1999

Eur Respir J

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This study was designed to identify a core set of items that may characterize impaired health in chronic respiratory failure (CRF) since none of the questionnaires commonly used to measure impaired health in patients with CRF were developed for use in such patients.Questionnaire items, identified from several sources, were administered to 92 patients with stable severe chronic hypoxia or hypercapnia, together with physiological measures of disease severity, the Sickness Impact Profile (SIP) and the St George's Respiratory Questionnaire (SGRQ).Of the 152 items identified, only 28 correlated with patients' perceptions of overall health and were also independent of age, sex, disease or type of treatment and did not show floor or ceiling effects. Principal components analysis identified three specific factors: "daily activities", "cognitive function", and "invalidity". The total score for the whole 28-item set correlated with other measures of disease activity, including SGRQ (r=0.86) and SIP (r=0.70), but not spirometry. The interquartile range of the 28-item set was wider than that of the SGRQ or the SIP.This study characterized two areas of health impairment in chronic respiratory failure that had not previously been identified: effects of impaired cognitive function on daily life, and a sense of invalidity. The measurements properties of this 28-item set suggest that it may be a more discriminative instrument for patients with chronic respiratory failure than existing questionnaires.

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A progressive care programme for prolonged ventilatory failure: analysis of outcome

Abstract: Summary

Cited by 26 publications

References 27 publications

Validity and Reliability of a French Version of the MRF-28 Health-Related Quality of Life Questionnaire

Validity and Reliability of a French Version of the MRF-28 Health-Related Quality of Life Questionnaire

The changing role of mechanical ventilation in COPD

Sputum endothelin-1 is increased in cystic fibrosis and chronic obstructive pulmonary disease

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