[Home mechanical ventilation: the extra-hospital phase].

Home mechanical ventilation is the choice option, when there are no contraindications of medical or socio-economic order, in all cases of impossible complete weaning from ventilatory support. Easy to use, reliable and size limited positive pressure ventilators lead to a spread diffusion of this technique. In the patient/ventilator interface, tracheostomy is the golden choice for patient with great reduction in spontaneous ventilatory ability. For all other patients, perfectioning of non-invasive access (nasal and oral nasal mask) represent an effective progress. Major limitations in home ventilation are still, up to present, the lack of multidisciplinary structures able to give territorial assistance. Home ventilation therapy in the experience of the Policlinico Universtitario "La Sapienza", Rome is presented.