Home-Based Care Evolution in Chronic Respiratory Failure between 2001 and 2015 (Antadir Federation Observatory)

Melloni, B.; Mounier, L.; Laaban, J. P.; Chambellan, Arnaud; Foret, D.; Muir, Jean-François

doi:10.1159/000490549

Cited by 22 publications

(24 citation statements)

References 20 publications

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“…Despite the physiologic benefits of CPAP, several surveys of home ventilation practices show that OHS is a major indication for home nocturnal NIV therapy ( 83 – 85 ). In part, NIV prescription in the home setting may follow its initial prescription for acute respiratory failure ( 26 , 27 ), without consideration of switching to CPAP ( 86 ).…”

Section: Resultsmentioning

confidence: 99%

Evaluation and Management of Obesity Hypoventilation Syndrome. An Official American Thoracic Society Clinical Practice Guideline

Mokhlesi¹,

Masa²,

Brožek³

et al. 2019

Am J Respir Crit Care Med

189

158

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; on behalf of the American Thoracic Society Assembly on Sleep and Respiratory Neurobiology THIS OFFICIAL CLINICAL PRACTICE GUIDELINE OF THE AMERICAN THORACIC SOCIETY WAS APPROVED MAY 2019 Background: The purpose of this guideline is to optimize evaluation and management of patients with obesity hypoventilation syndrome (OHS). Methods: A multidisciplinary panel identified and prioritized five clinical questions. The panel performed systematic reviews of available studies (up to July 2018) and followed the Grading of Recommendations, Assessment, Development, and Evaluation evidence-to-decision framework to develop recommendations. All panel members discussed and approved the recommendations. Recommendations: After considering the overall very low quality of the evidence, the panel made five conditional recommendations. We suggest that: 1) clinicians use a serum bicarbonate level ,27 mmol/L to exclude the diagnosis of OHS in obese patients with sleepdisordered breathing when suspicion for OHS is not very high (,20%) but to measure arterial blood gases in patients strongly suspected of having OHS, 2) stable ambulatory patients with OHS receive positive airway pressure (PAP), 3) continuous positive airway pressure (CPAP) rather than noninvasive ventilation be offered as the first-line treatment to stable ambulatory patients with OHS and coexistent severe obstructive sleep apnea, 4) patients hospitalized with respiratory failure and suspected of having OHS be discharged with noninvasive ventilation until they undergo outpatient diagnostic procedures and PAP titration in the sleep laboratory (ideally within 2-3 mo), and 5) patients with OHS use weight-loss interventions that produce sustained weight loss of 25% to 30% of body weight to achieve resolution of OHS (which is more likely to be obtained with bariatric surgery). Conclusions: Clinicians may use these recommendations, on the basis of the best available evidence, to guide management and improve outcomes among patients with OHS.

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Section: Resultsmentioning

confidence: 99%

Evaluation and Management of Obesity Hypoventilation Syndrome. An Official American Thoracic Society Clinical Practice Guideline

Mokhlesi¹,

Masa²,

Brožek³

et al. 2019

Am J Respir Crit Care Med

189

158

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“…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

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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.

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“…Academic and Clinical Dept of Sleep and Breathing, Royal Brompton Hospital, London, UK 2. National Heart and Lung Institute, Imperial College London, London, UK.…”

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confidence: 99%

The treatment burden of long-term home noninvasive ventilation

Spurr

2021

Breathe

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Cite as: Spurr L. The treatment burden of long-term home noninvasive ventilation. Breathe 2021; 17: 200291. @ERSpublications Long-term home noninvasive ventilation has practical and psychosocial implications for individuals, families and caregivers. Exploring the impact of the workload of healthcare or "treatment burden" helps determine treatment feasibility and acceptability. https://bit.ly/39YUY2A @DrLydiaSpurr

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Home-Based Care Evolution in Chronic Respiratory Failure between 2001 and 2015 (Antadir Federation Observatory)

Cited by 22 publications

References 20 publications

Evaluation and Management of Obesity Hypoventilation Syndrome. An Official American Thoracic Society Clinical Practice Guideline

Evaluation and Management of Obesity Hypoventilation Syndrome. An Official American Thoracic Society Clinical Practice Guideline

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

The treatment burden of long-term home noninvasive ventilation

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