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Respiratory Care |

Home Mechanical Ventilation: Indications, Critical and Practical Experience FREE TO VIEW

Alessandro MASTINU, MD; Tiziana Stobbione, PhD
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Pneumology Unit, Cardinal Massaia Hospital, Asti, Italy


Chest. 2015;148(4_MeetingAbstracts):1017A. doi:10.1378/chest.2262390
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Abstract

SESSION TITLE: Respiratory Care Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: To describe the NIMV home care situation in Asti (Italy) analyzing whether the categories of patients undergoing to mechanical ventilation there have been results in terms of efficacy of treatment, compliance and clinical impact.

METHODS: Retrospective study of a sample of 55 consecutive patients included in the program of in-home long term noninvasive mechanical ventilation at the Pneumology Unit Hospital "Cardinal Massaia" of Asti. Were performed regression analysis and evaluation of statistical significance through the t-test. It was accepted statistical significance of p <0.05. The analysis covered the blood gas and ventilatory parameters, compliance to mechanical ventilation, the changes induced by the treatment on the frequency of COPD exacerbations and the level of daytime sleepiness.

RESULTS: Patients examined with a diagnosis of COPD, kyphoscoliosis and "overlap syndrome" came from the sleep clinic and showed some degree of daytime sleepiness and daytime hypercapnia with a significant acid-base balance offset. A significant percentage (12/22 with COPD and 5/8 with kyphoscoliosis) had daytime hypoxemia at rest. The patients performed NIMV in pressure mode, as prescribed, for a daily average of 5.1 ± 1.1 hours. The data analysis shows a significant improvement at six months of general conditions during wakefulness with residual daytime hypoxemia only in 5 with COPD patients and in 1 with kyphoscoliosis and a sharp reduction of daytime sleepiness. The compliance to treatment was good and the number of respiratory exacerbations was reduced.

CONCLUSIONS: The results of the study show an improvement in symptoms, daytime performance and respiratory failure during wakefulness and a good compliance to treatment. In order to determine the real benefit of long-term ventilation in patients with chronic respiratory insufficiency is conceivable implementation of randomized controlled trials evaluating quality of life indices.

CLINICAL IMPLICATIONS: It is well known in the medical literature that non-invasive ventilation offers advantages in the management of acute respiratory failure by reducing the incidence of endotracheal intubation, morbidity and mortality in patients with severe exacerbations of chronic obstructive pulmonary disease. The extension of complex treatments at home helps to give dignity to people and support for families.

DISCLOSURE: The following authors have nothing to disclose: Alessandro MASTINU, Tiziana Stobbione

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