Analysis of home support and ventilator malfunction in 1,211 ventilator-dependent patients

Home Mechanical Ventilation in Canada: A National Survey

“…24 Issues relating to ventilator equipment failure are not infrequent. In the United Kingdom, Chatwin and colleagues 25 reported on 1,211 ventilator-assisted individuals receiving NIV over a 6-month time frame and found an 8% failure rate per NIV device manufacturer, with higher failure rates in highly ventilator-dependent individuals and older devices. An earlier study of mostly tracheostomized ventilatorassisted individuals reported 189 equipment-associated issues in 150 users over 1 y and found that 43% were due to improper use or care of equipment by caregivers.…”

Home ventilation: need a user support number?

“…In the present issue of the European Respiratory Journal, CHATWIN et al [1] present data on the call centre they established to support more than 1,000 patients on home respirators. The Respiratory Unit of the Royal Brompton Hospital (London, UK) serves a vast geographical area.…”

“…These calls can be made for a number of reasons; from simple concerns such as asking for spare part replacement, to more disturbing ones such alarms coming on during the night or to a respirator becoming noisy all of a sudden, to very serious ones such as a respirator breakdown in a respirator dependent patient. CHATWIN et al [1] have recorded and analysed all calls received during a 6-month period, from a population of 1,211 patients, from paediatrics to geriatrics, who were followed up at their centre. All patients had had a training process within the Royal Brompton Hospital unit, and all patients or families were deemed able to understand the use of home respirators, adequately fit and assembly/disassembly the mask and interfaces, start and stop the machines, and even to unlock the settings in order to change them according to telephonic instructions if this was thought useful by the on-call personnel.…”

“…In 25 visits, no faulty equipment was identified, and 13 of these 25 patients had had a change in their medical condition or required hospital admission. When investigating respirator breakdowns, CHATWIN et al [1] found an increased malfunction rate in older respirators that had served for .8 yrs, as well as in new respirators on the market. There was also a high breakdown rate in highly dependent patients who used respirators for .16 h per day.…”

“…Many of the characteristics of the system implemented by CHATWIN et al [1] depend on their particular practice, with a large geographic area to cover. In other circumstances, as is the case in our laboratory, the personnel of the centre could accompany the patients on the first day of home ventilation to verify the placing of the respirator in the bedroom, the availability of electrical connections, the level of autonomy of the patients and family to place the mask interface and so on [2].…”