Literature DB >> 23764860

Long-term mechanical ventilation equipment for neuromuscular patients: meeting the expectations of patients and prescribers.

Frédéric Lofaso1, Hélène Prigent, Vincent Tiffreau, Nathalie Menoury, Michel Toussaint, Armelle Finet Monnier, Natalie Stremler, Christian Devaux, Karl Leroux, David Orlikowski, Cécile Mauri, Isabelle Pin, Sabrina Sacconi, Cécile Pereira, Jean-Louis Pépin, Brigitte Fauroux.   

Abstract

BACKGROUND: To maximize the likelihood of successful long-term mechanical ventilation (MV) in patients with neuromuscular diseases, ventilator characteristics and settings must be chosen carefully, taking into account both medical requisites and the patient's preference and comfort.
OBJECTIVES: To evaluate patients' knowledge about and comfort with their long-term MV; to compare patients' and prescribers' opinions and expectations regarding long-term MV; and to compare the equipment used by the patients to the prescribers' current MV prescription.
METHODS: Neuromuscular patients receiving long-term MV, and home MV prescribers in Belgium and France were asked to respond to a questionnaire survey specifically developed for the study.
RESULTS: Completed questionnaires were collected from 209 patients (mean age 35.4 ± 15.9 y, range 3-86 y), ventilated since 11 ± 17 year, and 45 MV prescribers. One hundred sixty-three (78%) patients correctly designated their MV mode as a volume or pressure controlled mode. When an inspiratory trigger was available, 92% of the patients were able to use it, but only 69% were satisfied. Prescribers were more prone than patients to use new technologies such as an emergency-release system for the noninvasive interface (1-10 visual analog scale score 9.2 ± 1.5 vs 6.8 ± 3.3, P < .001), a humidification system (8.6 ± 1.4 vs 7.8 ± 2.6, P = .02), a contactor for providing larger inspiratory volumes (8.4 ± 1.7 vs 6.0 ± 3.0, P = .009), a built-in cough assistance mode (9.2 ± 1.4 vs 5.5 ± 3.5, P < .001), new options to improve speech, or new MV modes such as a volume-targeted pressure control.
CONCLUSIONS: The opinions of patients and prescribers differed about the ideal home ventilator. Patients were less prone to use new technologies, mainly because of a lack of information, underlining the need for regular MV update in patients receiving long-term MV.

Entities:  

Keywords:  home care; masks; mouthpieces; myopathies; patient-centered care; respiratory failure

Mesh:

Year:  2013        PMID: 23764860     DOI: 10.4187/respcare.02229

Source DB:  PubMed          Journal:  Respir Care        ISSN: 0020-1324            Impact factor:   2.258


  3 in total

Review 1.  Respiratory assessment in centronuclear myopathies.

Authors:  Barbara K Smith; Melissa Goddard; Martin K Childers
Journal:  Muscle Nerve       Date:  2014-08-05       Impact factor: 3.217

2.  Physiological predictors of respiratory and cough assistance needs after extubation.

Authors:  Nicolas Terzi; Frédéric Lofaso; Romain Masson; Pascal Beuret; Hervé Normand; Edith Dumanowski; Line Falaize; Bertrand Sauneuf; Cédric Daubin; Jennifer Brunet; Djillali Annane; Jean-Jacques Parienti; David Orlikowski
Journal:  Ann Intensive Care       Date:  2018-02-05       Impact factor: 6.925

3.  Effect of a passive exhalation port on tracheostomy ventilation in amyotrophic lateral sclerosis patients: a randomized controlled trial.

Authors:  Andrea Vianello; Giovanna Arcaro; Beatrice Molena; Silvia Iovino; Federico Gallan; Cristian Turato; Rosario Marchese-Ragona
Journal:  J Thorac Dis       Date:  2018-02       Impact factor: 2.895

  3 in total

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