Jacek Nasiłowski1, Mariusz Wachulski2, Wojciech Trznadel3, Witalij Andrzejewski4, Marek Migdał5, Wojciech Drozd6, Andrzej Pytel7, Robert Suchanke7, Małgorzata Czajkowska-Malinowska8, Tomasz Majszyk9, Zbigniew Szkulmowski10, Ryszarda Chazan11. 1. Department of Internal Medicine, Pneumology and Allergology, Medical University of Warsaw, Warsaw, Poland. jnasilowski@wum.edu.pl. 2. Home Mechanical Ventilation Center, Dom Sue Ryder, Bydgoszcz, Poland. 3. Home Mechanical Ventilation Center, VentaMed, Zielona Góra, Poland. 4. Lodz Hospice for Children, Łódź, Poland. 5. Pediatric Intensive Care Unit, Children's Memorial Health Institute, Warsaw, Poland. 6. Home Mechanical Ventilation Center, BetaMed, Katowice, Poland. 7. Home Mechanical Ventilation Center, HELP, Poznań, Poland. 8. Department of Pulmonary Diseases and Respiratory Failure, Kuyavian-Pomeranian Regional Pulmonology Centre, Bydgoszcz, Poland. 9. Home Mechanical Ventilation Center, St Vincent Medical Center, Warsaw, Poland. 10. Home Ventilation Center, Medycyna Specjalistyczna, Bydgoszcz, Poland. 11. Department of Internal Medicine, Pneumology and Allergology, Medical University of Warsaw, Warsaw, Poland.
Abstract
BACKGROUND: Home mechanical ventilation (HMV) is a routine method of treatment for patients with chronic ventilatory failure. Over the last 20 y, a marked development in HMV has been noted in terms of its prevalence and the changing proportion of patients with various indications. However, data on HMV come exclusively from the developed countries of Europe and North America. Nowadays, we can see the emergence of HMV in less developed countries. This study aimed to describe the development of HMV in Poland. METHODS: Data from the largest HMV centers were retrospectively evaluated with regard to cause of respiratory failure, ventilation technique, and characteristics of the HMV-implementing institution. RESULTS: The number of subjects treated with HMV increased from 8 in 2000 to 928 in 2010. Neuromuscular diseases remained the main indication. However, their relative contribution decreased from 100 to 51% in favor of pulmonary diseases (an increase from 0 to 21%) and hypoventilation syndromes (0% in 2000 and 11% in 2010). The majority of the HMV population treated between 2000 between 2008 was ventilated by tracheostomy; however, since 2007, the percentage of subjects on noninvasive ventilation significantly increased and was equal to the number of tracheostomized subjects. HMV was initiated mainly in ICUs. However, their role systematically diminished, and an increasing number of subjects were recruited in respiratory departments. CONCLUSIONS: The prescription pattern of HMV in Poland has evolved, and there is a clear shift from neuromuscular to respiratory diseases. The prevalence of ventilation via tracheostomy still remains very high in comparison with other European countries. The Polish experience could be useful for countries with emerging HMV care systems.
BACKGROUND: Home mechanical ventilation (HMV) is a routine method of treatment for patients with chronic ventilatory failure. Over the last 20 y, a marked development in HMV has been noted in terms of its prevalence and the changing proportion of patients with various indications. However, data on HMV come exclusively from the developed countries of Europe and North America. Nowadays, we can see the emergence of HMV in less developed countries. This study aimed to describe the development of HMV in Poland. METHODS: Data from the largest HMV centers were retrospectively evaluated with regard to cause of respiratory failure, ventilation technique, and characteristics of the HMV-implementing institution. RESULTS: The number of subjects treated with HMV increased from 8 in 2000 to 928 in 2010. Neuromuscular diseases remained the main indication. However, their relative contribution decreased from 100 to 51% in favor of pulmonary diseases (an increase from 0 to 21%) and hypoventilation syndromes (0% in 2000 and 11% in 2010). The majority of the HMV population treated between 2000 between 2008 was ventilated by tracheostomy; however, since 2007, the percentage of subjects on noninvasive ventilation significantly increased and was equal to the number of tracheostomized subjects. HMV was initiated mainly in ICUs. However, their role systematically diminished, and an increasing number of subjects were recruited in respiratory departments. CONCLUSIONS: The prescription pattern of HMV in Poland has evolved, and there is a clear shift from neuromuscular to respiratory diseases. The prevalence of ventilation via tracheostomy still remains very high in comparison with other European countries. The Polish experience could be useful for countries with emerging HMV care systems.
Authors: Kyunghyun Song; Sei-Won Kim; Yun Su Sim; Tai Sun Park; Young Seok Lee; Jick Hwan Ha; Ji Young Park; Ki-Suck Jung; Sunghoon Park Journal: J Thorac Dis Date: 2021-07 Impact factor: 2.895