Abstract | BACKGROUND: Long-term home mechanical ventilation (HMV) is usually initiated in hospital. Admission to hospital has resource implications and may not be reimbursable in some healthcare systems. METHODS: Twenty-eight stable neuromuscular and chest wall disease patients with nocturnal hypoventilation (transcutaneous carbon dioxide (TcCO(2) >6.5 kPa), were randomised to start HMV either as an outpatient (n=14, age range 12-62 years) or inpatient (n=14, age range 14-73 years). We compared effects of HMV on nocturnal and diurnal arterial blood gas tensions, ventilator compliance, healthcare professional (HCP) contact time, and time in hospital. RESULTS: Improvements in nocturnal arterial oxygen saturation (SaO(2)) and daytime PaO(2) were equivalent in both groups. Peak nocturnal TcCO(2), improved in both groups; % time TcCO(2) >6.5 kPa fell in the inpatient group and daytime PaCO(2) decreased significantly (p<0.05) in the outpatient group. The mean (SD) inpatient stay was 3.8 (1.0) days, and the outpatient attendance sessions 1.2 (0.4). HCP contact time including telephone calls was: inpatient 177 (99) min; outpatient 188 (60) min (p=not significant); 2 month ventilator compliance was: inpatient 4.32 (7); outpatient 3.92 (8) (p=not significant) hours per night. CONCLUSION: Outpatient initiation of HMV is feasible with equivalent outcome in the outpatient and the inpatient groups.
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Authors | Michelle Chatwin, Annabel H Nickol, Mary J Morrell, Michael I Polkey, Anita K Simonds |
Journal | Respiratory medicine
(Respir Med)
Vol. 102
Issue 11
Pg. 1528-35
(Nov 2008)
ISSN: 1532-3064 [Electronic] England |
PMID | 18774702
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Blood Gas Analysis
- Child
- Female
- Home Care Services, Hospital-Based
(organization & administration)
- Hospitalization
(statistics & numerical data)
- Humans
- Hypoventilation
(blood, psychology, therapy)
- Length of Stay
- Male
- Middle Aged
- Neuromuscular Diseases
(complications)
- Quality of Life
(psychology)
- Respiration, Artificial
(methods, psychology)
- Sleep Apnea Syndromes
(blood, psychology, therapy)
- Surveys and Questionnaires
- Vital Capacity
(physiology)
- Young Adult
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