Choosing a ventilator for home mechanical ventilation

Gregoretti, Cesare; Navalesi, Paolo; S, Ghannadian; Carlucci, Annalisa; Pelosi, Paolo

doi:10.1183/20734735.042312

Cited by 26 publications

(38 citation statements)

References 61 publications

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“…However, although in the past these systems had a clear responsiveness advantage compared with dynamic blower systems, recent developments show that dynamic blowers with a small turbine size and a high revolution rate per minute are also extremely responsive to patient demand. 21 In contrast, CPAP is usually provided by a CPAP flow generator that delivers constant positive pressure or by mechanical ventilators. 32,33 Ventilators can deliver noninvasive positive pressure to the patient's airway by the respiratory circuit (RC) connected to the interface.…”

Section: Types Of Ventilatorsmentioning

confidence: 99%

“…25 Although new highly compressed gas-driven ICU ventilators have embedded NIV algorithms to manage leaks and to promote improved patientventilator synchrony 23,26 by adjusting triggering, flow, and cycling mechanisms, turbine-driven ventilators in their intentional-leak circuit configuration may outperform compressed-driven ventilators in ICUs. 21,23,[27][28][29][30] All ventilators, except for portable transport ventilators that may be driven pneumatically, require electricity (alternating current external power or a direct current internal battery). The gas source can be (1) external high-pressure gas (centralized gas system or tanks), (2) an internal compressor, (3) a turbine or piston; (4) a combination of (1) and (3) or (1) and (2).…”

Section: Types Of Ventilatorsmentioning

confidence: 99%

“…NPPV may be delivered by traditional highly compressed gas-driven ICU ventilators, or dedicated turbine-driven or micropiston-driven NIV ventilator. [21][22][23] Basic knowledge of the principles of ventilator functioning may be helpful when choosing a ventilator for NIV. 24 This knowledge enables physicians/respiratory therapists to consider the ventilator's technical performance in relation to the patient's clinical characteristics, underlying disease, the setting, and the available financial resources.…”

Section: Types Of Ventilatorsmentioning

confidence: 99%

See 2 more Smart Citations

Noninvasive Ventilation in Critically Ill Patients

Gregoretti

Pisani

Cortegiani

et al. 2015

Critical Care Clinics

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Section: Types Of Ventilatorsmentioning

confidence: 99%

Section: Types Of Ventilatorsmentioning

confidence: 99%

Section: Types Of Ventilatorsmentioning

confidence: 99%

See 1 more Smart Citation

Noninvasive Ventilation in Critically Ill Patients

Gregoretti

Pisani

Cortegiani

et al. 2015

Critical Care Clinics

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“…Technological improvements in ventilators, ventilator modes, interface design, and secretion removal techniques have simplified NIV use, increasing patients’ comfort and HRQL [24-29]. …”

Section: Modes and Monitoringmentioning

confidence: 99%

Long-Term Ventilation in Neuromuscular Patients: Review of Concerns, Beliefs, and Ethical Dilemmas

Crimi

Pierucci²,

Carlucci

et al. 2019

Respiration

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Background: Noninvasive mechanical ventilation (NIV) is an effective treatment in patients with neuromuscular diseases (NMD) to improve symptoms, quality of life, and survival. Summary: NIV should be used early in the course of respiratory muscle involvement in NMD patients and its requirements may increase over time. Therefore, training on technical equipment at home and advice on problem solving are warranted. Remote monitoring of ventilator parameters using built-in ventilator software is recommended. Telemedicine may be helpful in reducing hospital admissions. Anticipatory planning and palliative care should be carried out to lessen the burden of care, to maintain or withdraw from NIV, and to guarantee the most respectful management in the last days of NMD patients’ life. Key Message: Long-term NIV is effective but challenging in NMD patients. Efforts should be made by health care providers in arranging a planned transition to home and end-of-life discussions for ventilator-assisted individuals and their families.

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“…A single-limb non-vented circuit has an exhalation valve controlled by the ventilator at the distal end of the circuit [35]. A double-limb circuit consists of an inspiratory and expiratory limb (Fig.…”

Section: Selection Of the Ventilator Circuit And Settingsmentioning

confidence: 99%

Frontiers in Clinical Practice of Long-Term Care of Chronic Ventilatory Failure

Schwarz

Bloch

2019

Respiration

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Home mechanical ventilation (HMV) is an effective long-term treatment for chronic hypercapnic respiratory failure. In addition to the established practice of providing HMV for the treatment of chronic ventilatory failure in slowly progressive neuromuscular and chest wall disease, there is accumulating evidence for improvement of quality of life and prolongation of survival by HMV in highly prevalent diseases like chronic obstructive pulmonary disease and ever-increasing obesity hypoventilation syndrome as well as rapidly progressive neuromuscular disease. The key concepts for successful HMV are an experienced team selecting the right patients, timely initiation of adequate ventilation via an appropriate interface, and monitoring effectiveness during regular long-term follow-up. Coaching of patients with chronic respiratory failure on long-term HMV within a dedicated service and collaborations with community services for home care are essential. The current review describes various important practical aspects of HMV that remain frontiers in the implementation of the current knowledge in clinical practice and may help in providing effective HMV to all those in need.

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Choosing a ventilator for home mechanical ventilation

Cited by 26 publications

References 61 publications

Noninvasive Ventilation in Critically Ill Patients

Noninvasive Ventilation in Critically Ill Patients

Long-Term Ventilation in Neuromuscular Patients: Review of Concerns, Beliefs, and Ethical Dilemmas

Frontiers in Clinical Practice of Long-Term Care of Chronic Ventilatory Failure

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