Clinical considerations in the implementation of home care ventilation: observations in 24 patients

Ed, Sivak; Em, Cordasco; Wt, Gipson; K, Stelmak

doi:10.3949/ccjm.50.2.219

Cited by 13 publications

(1 citation statement)

References 6 publications

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“…1,2,[11][12][13][14] The only exception to this protocol was Patient 17, who was hospitalized with an episode of respiratory failure and invasive ventilation with weaning to NIPPV. Non-invasive ventilation was accomplished with either BiPAP r (Respironics, Murraysville, PA) or Quantum PSV (Healthdyne Technologies, Marietta, GA).…”

Section: Patient Population and Methodsmentioning

confidence: 99%

The use of non-invasive positive pressure ventilation (NIPPV) in ALS patients. A need for improved determination of intervention timing

Sivak

Shefner

Mitsumoto

et al. 2001

Amyotrophic Lateral Sclerosis and Other Motor Neuron Disorders

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We present our experience with 27 patients with symptoms of alveolar hypoventilation, a precursor to respiratory failure, to demonstrate variability in symptoms, physiologic status and outcome of intervention. They represent 27 consecutive patients who tolerated NIPPV for more that 4 hours per 24-h period for more than 2 weeks. All patients received neurological consultation, electromyography and met criteria for ALS according to El Escorial diagnostic criteria. To assess respiratory status, spirometry was measured in sitting and when possible, in the supine positions. Resting arterial blood gases were available in 22 patients. Orthopnea was the most common symptom at the time of institution of NIPPV. No correlation existed between age at institution of NIPPV, duration of effective use of this technology or vital capacity and duration of effective use of NIPPV. The lack of correlation between vital capacity at the institution of NIPPV and duration of its effectiveness suggest that more sensitive indicators for the onset of alveolar hypoventilation must be defined, particularly since the principal benefit from its use is relief of symptoms of alveolar hypoventilation.

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Section: Patient Population and Methodsmentioning

confidence: 99%

The use of non-invasive positive pressure ventilation (NIPPV) in ALS patients. A need for improved determination of intervention timing

Sivak

Shefner

Mitsumoto

et al. 2001

Amyotrophic Lateral Sclerosis and Other Motor Neuron Disorders

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Assisted ventilation at home: Is it worth considering?

Kinnear

Shneerson

1985

British Journal of Diseases of the Chest

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Mortality outcomes of patients on chronic mechanical ventilation in different care settings: A systematic review

Sison

Sivakumar

Caufield-Noll

et al. 2021

Heliyon

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Objectives To determine the outcomes of chronically ventilated patients outside the setting of intensive care units. Design Systematic review. Setting and participants Studies evaluating patients on chronic invasive mechanical ventilation in different care settings. Methods A systematic literature search of the PubMed, Embase, Cochrane Library, CINAHL (EBSCOhost), LILACS and Scopus databases from inception to March 27, 2020. Studies reporting mortality outcomes of patients ≥18 years of age on chronic invasive mechanical ventilation in intensive care units and other care settings were eligible for inclusion. Results Sixty studies were included in the systematic review. Mortality rates ranged from 13.7% to 77.8% in ICUs (n = 17 studies), 7.8%–51.0% in non-ICUs including step-down units and inpatient wards (n = 26 studies), and 12.0%–91.8% in home or nursing home settings (n = 19 studies). Age was associated with mortality in all care settings. Weaning rates ranged from 10.0% to 78.2% across non-ICU studies. Studies reporting weaning as their primary outcome demonstrated higher success rates in weaning. Home care studies reported low incidences of ventilator failure. None of the studies reported ventilator malfunction as the primary cause of death. Conclusions and implications Mortality outcomes across various settings were disparate due to methodological and clinical heterogeneity among studies. However, there is evidence to suggest non-ICU venues of care as a comparable alternative to ICUs for stable, chronically ventilated patients, with the additional benefit of providing specialized weaning programs. By synthesizing the global data on managing chronically ventilated patients in various care settings, this study provides health care systems and providers alternative venue options for the delivery of prolonged ventilatory care in the context of limited ICU resources.

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Clinical considerations in the implementation of home care ventilation: observations in 24 patients

Cited by 13 publications

References 6 publications

The use of non-invasive positive pressure ventilation (NIPPV) in ALS patients. A need for improved determination of intervention timing

The use of non-invasive positive pressure ventilation (NIPPV) in ALS patients. A need for improved determination of intervention timing

Assisted ventilation at home: Is it worth considering?

Mortality outcomes of patients on chronic mechanical ventilation in different care settings: A systematic review

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