Abstract

MAGALI, Blanco et al. Monitoreo de la ventilación domiciliaria crónica: Experiencia basada en un modelo de hospital de día. Rev. am. med. respir. [online]. 2018, vol.18, n.3, pp.152-161. ISSN 1852-236X.

Introduction: Home mechanical ventilation (HMV) represents a standard of care for chronic ventilatory pump failure. The care model could be determinant in deficiencies in the control of quality of HMV. Material and methods: In order to monitoring compliance during home mechanical ventilation and optimize its effectiveness, we proposed a program through a day hospital conducted by pulmonology doctors and respiratory physiotherapist. A descriptive study was designed on a systematic collection database. Participants were consecutive patients with NIV or mechanical invasive ventilation (MIV) assisted in the Pulmonology Service between July 2014 and December 2016. Results: During 30 months we included 94 patients; 52 men (55%), age 64.4 ± 15.9 years and BMI of 28.6 ± 8.46 kg / m². Fifty percent were obese or overweight. 80 were found with HMV (84%) noninvasive (NIV) in 77 cases and invasive in three (4%). 15 patients (16%) were admitted to evaluate indication of VMD. The NIV modes used were; Bilevel S / T: 59 (62.7%), AVAPS; 4 (4.2%), CPAP: 6 (6.4%), servo-ventilation: 1 (1%). Three patients received volumetric ventilation. The mean compliance objectively measured was 8.1 hours. Four patients did not use the device. Remained with hypercapnia 42.5%. The setting was changed in 37 patients (46.2%), ventilatory mode in 2 (2.5%) and HMV was suspended in two (2.5%). In individual patients adjustments were clinically significant. Conclusion: This program allowed to improve the training and to identify a high percentage of patients with ineffective HMV, allowing adjustments in the modality of treatment.

Keywords : Home mechanical ventilation; Non-invasive ventilation; Monitoring.

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