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Home Mechanical Ventilation (home + mechanical_ventilation)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Home mechanical ventilation in children: Retrospective survey of a pediatric population

PEDIATRICS INTERNATIONAL, Issue 6 2007
GIANCARLO OTTONELLO
Abstract Background: Home care support is beneficial for children needing mechanical ventilation, when clinically stable. Methods: A retrospective analysis was carried out of the long-term home ventilation management of a pediatric population with chronic respiratory failure composed of 20 ventilator-dependent children categorized according to age, diagnosis and ventilation support. Age groups consisted of 10% under 1 year, 30% between 2 and 5 years, 30% between 6 and 12 years, and 30% older than 12 years. Diagnostic categories included myopathic disorder, n = 5; congenital central hypoventilation syndrome, n = 6; chest wall disorder, n = 5; cystic fibrosis, n = 1; pulmonary hypertension, n = 1; and diaphragmatic paralysis, n = 2. Results: Sixty-five percent were ventilated using non-invasive mode (NIMV): eight with nasal mask, five with full-face mask, and two children in NIMV also used negative pressure mode; 35% were ventilated using tracheostomy, one of them also used a diaphragmatic pacer. Seventy percent needed nocturnal ventilatory support, (20% 12,18 h, 10% full-day). A total of 18 children were included in the home care and follow-up program. Two children died: one because of worsening of his chronic disease and one because of septic shock. Conclusion: Although home care ventilation is not yet widely diffused, it represents a valid alternative to long hospitalization for children with stable chronic respiratory failure. [source]

Clients' experiences of living at home with a mechanical ventilator

JOURNAL OF ADVANCED NURSING, Issue 2 2009
Randi Ballangrud
Abstract Title.,Clients' experiences of living at home with a mechanical ventilator. Aim., This paper reports on a study of how clients experience living with home mechanical ventilation and how they experience care and supervision of healthcare personnel. Background., The number of people living at home with mechanical ventilators is increasing, and this is considered a successful approach to reducing incapacity and mortality. Method., Qualitative interviews were conducted with 10 service users in 2006. The informants were 18,75 years old and had varying diagnoses and levels of functioning. The interviews were tape recorded, transcribed and analysed by qualitative content analysis. Findings., Two main themes emerged: Theme 1. Having a home ventilator enhances quality of life , a life worth living. The ventilator treatment builds up strength and improves well-being. Participants emphasized that it was important to feel in control of their own situation and had an overriding wish to live a normal and active life; Theme 2. Competence and continuity of healthcare personnel are factors for success. The experience was that competence and follow-up by healthcare personnel varied, and that good quality teaching and information were important. Conclusion., Users of home mechanical ventilators should be active partners in their own care so that their experience is taken into account. It is important for clients having home mechanical ventilation to be empowered and have control in their daily lives, as well as having competent caregivers and continuity of care. [source]

A retrospective survey of outpatients with long-term tracheostomy

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2006
G. Björling
Background:, The Respiratory Unit (RU) at Danderyd University Hospital opened in 1982, with the expressed goal of supporting outpatients with long-term tracheostomy. The primary aim of this retrospective study in tracheostomized patients was to compare the need for hospital care in the 2-year period before and after the tracheostomy. Methods:, Data were collected from patient medical records at the RU, from the National Board of Health and Welfare, Sweden and from the Official Statistics of Sweden. The subjects were RU patients in 1982 (Group 1, n = 27) and in 1997 (Group 2, n = 106) with long-term tracheostomy surviving at least 4 years after the tracheostomy. Results:, Both groups had few and unchanged needs for hospital care after tracheostomy. They spent ,,96% of their time out of hospital. In 1997, (group 2) the number of patients, diagnoses and need for home mechanical ventilation had increased. Life expectancy was assessed for patients in Group 1. Data showed that they lived as long as an age-matched and gender-adjusted control cohort. Conclusions:, Long-term tracheostomy may not increase the need for hospital care and does not reduce life expectancy. These clinical observations were made in a setting where patients had regular access to a dedicated outpatient unit. [source]

Children with corrected or palliated congenital heart disease on home mechanical ventilation,

PEDIATRIC PULMONOLOGY, Issue 7 2010
Jeffrey D. Edwards MD
Abstract Infants and children with surgically corrected or palliated congenital heart disease (CHD) are at risk for chronic respiratory failure, necessitating home mechanical ventilation (HMV) via tracheostomy. However, very little data exists on this population or their outcomes. We conducted a retrospective chart review of all children with CHD enrolled in the Childrens Hospital Los Angeles HMV program between 1994 and 2009. Data were collected on type of heart lesion, surgeries performed, number of failed extubations, timing of tracheostomy, mortality, length of time on HMV, weaning status, associated co-morbidities, and Risk Adjusted classification for Congenital Heart Surgery (RACHS-1) category. Thirty-five children were identified; six with single ventricle anatomy, who received palliative procedures. Twenty-three (66%) patients are alive; 8 (23%) living patients have been weaned off HMV. Twelve (34%) patients are deceased. The incidence of mortality for single ventricle patients was 50%, and only one of the surviving children has received final palliation and weaned off HMV. Eight of nine patients (89%) with a RACHS score ,4 died, and none have been weaned off of HMV. The 5-year survival for all CHD HMV patients was 68%; 90% for patients with RACHS ,3; and 12% for patients with score ,4. Children with more complex lesions, as demonstrated by single ventricle physiology or greater RACHS scores, had higher mortality rates and less success weaning off HMV. This case series suggests that caregivers should give serious consideration to the type of heart defect as they advise families considering HMV in children with CHD. Pediatr Pulmonol. 2010; 45:645,649. © 2010 Wiley-Liss, Inc. [source]