Current Practices in Home Mechanical Ventilation for Chronic Obstructive Pulmonary Disease: A Real-Life Cross-Sectional Multicentric Study
| Autor: | Carla Ribeiro, Ana Luísa Vieira, Paula Pamplona, Alexandra Carreiro, João Cravo, Marta Drummond, Luísa Castro, Teresa Martin, Diva Ferreira, Filipa Carriço, Sara Conde, Mónica Grafino, Inês Vicente, Hedi Liberato, Wolfram Windisch, Rui Nunes, Bárbara Seabra, Nélson Teixeira, Pedro Costa |
|---|---|
| Přispěvatelé: | Repositório Científico do Instituto Politécnico do Porto |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Exacerbation medicine.medical_treatment International Journal of Chronic Obstructive Pulmonary Disease chronic obstructive pulmonary disease Hypercapnia Pulmonary Disease Chronic Obstructive outpatient adaptation Positive airway pressure medicine Humans Outpatient adaptation Normocapnia Aged Original Research Mechanical ventilation COPD Noninvasive Ventilation business.industry Chronic obstructive pulmonary disease Sleep apnea General Medicine medicine.disease Obesity Home Care Services Respiration Artificial home mechanical ventilation Cross-Sectional Studies Home mechanical ventilation Emergency medicine Breathing Female business Noninvasive ventilation |
| Zdroj: | International Journal of Chronic Obstructive Pulmonary Disease Repositório Científico de Acesso Aberto de Portugal Repositório Científico de Acesso Aberto de Portugal (RCAAP) instacron:RCAAP |
| ISSN: | 1178-2005 |
| Popis: | Carla Ribeiro,1 Ana LuÃsa Vieira,2 Paula Pamplona,3 Marta Drummond,4,5 Bárbara Seabra,6 Diva Ferreira,7 Hedi Liberato,8 Alexandra Carreiro,9 Inês Vicente,10 LuÃsa Castro,11,12 Pedro Costa,13 Filipa Carriço,14 Teresa Martin,15 João Cravo,16 Nélson Teixeira,17 Mónica Grafino,18 Sara Conde,1 Wolfram Windisch,19,20 Rui Nunes5 1Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; 2Pulmonology Department, Hospital de Braga, Braga, Portugal; 3Pulmonology Department, Centro Hospitalar Universitário Lisboa Norte - Hospital Pulido Valente, Lisboa, Portugal; 4Centro de Responsabilidade Integrado Sono e VNI do Centro Hospitalar e Universitário São João, Porto, Portugal; 5Faculty of Medicine, Porto University, Porto, Portugal; 6Pulmonology Department, Hospital Pedro Hispano, Matosinhos, Portugal; 7Pulmonology Department, Centro Hospitalar do Médio Ave, Famalicão, Portugal; 8Pulmonology Department, Hospital Professor Doutor Fernando da Fonseca, Amadora, Portugal; 9Pulmonology Department, Hospital do Divino EspÃrito Santo de Ponta Delgada, Ponta Delgada, Portugal; 10Pulmonology Department, Centro Hospitalar Universitário da Cova da Beira, Covilhã, Portugal; 11MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal; 12School of Health of Polytechnic of Porto, Porto, Portugal; 13Pulmonology Functional Unit, Unidade Local de Saúde do Norte Alentejano, Portalegre, Portugal; 14Pulmonology Department, Unidade Local de Saúde da Guarda, Guarda, Portugal; 15Pulmonology Department, Hospital Beatriz Ãngelo, Loures, Portugal; 16Pulmonology Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal; 17Pulmonology Department, Unidade Local de Saúde do Nordeste, Bragança, Portugal; 18Pulmonology Department, Hospital da Luz, Lisboa, Portugal; 19Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University, Cologne, Germany; 20Faculty of Health/School of Medicine, Witten/Herdecke University, Cologne, GermanyCorrespondence: Carla RibeiroPulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, s/n, Vila Nova de Gaia, PortugalFax +35 1227868328Email carlafarinharibeiro@gmail.comPurpose: Home mechanical ventilation (HMV) use in chronic obstructive pulmonary disease (COPD) is becoming increasingly widespread. The aim of this study was to provide an accurate description of the current practices and clinical characteristics of COPD patients on HMV in Portugal.Methods: The study was designed as a cross-sectional, multicenter real-life study of COPD patients established on HMV for at least 30 days. Data related to clinical characteristics, adaptation and ventilatory settings were collected.Results: The study included 569 COPD patients on HMV from 15 centers. The majority were male, with a median age of 72 years and a high prevalence of obesity (43.2%) and sleep apnea (45.8%). A high treatment compliance was observed (median 8h/day), 48.7% with inspiratory positive airway pressure ⥠20 cmH2O and oronasal masks were the preferred interface (91.7%). There was an equal distribution of patients starting HMV during chronic stable condition and following an exacerbation. Patients in stable condition were initiated in the outpatient setting in 92.3%. Despite the differences in criteria and setting of adaptation and a slightly lower BMI in patients starting HMV following an exacerbation, we found no significant differences regarding age, gender, ventilation pressures, time on HMV, usage, severity of airflow obstruction or current arterial blood gas analysis (ABGs) in relation to patients adapted in stable condition.Conclusion: Patients were highly compliant with the therapy. In agreement with most recent studies and recommendations, there seems to be a move towards higher ventilation pressures, increased use of oronasal masks and an intent to obtain normocapnia. This study shows that chronic hypercapnic and post exacerbation patients do not differ significantly regarding patient characteristics, physiological parameters or ventilatory settings with one exception: chronic hypercapnic patients are more often obese and, subsequently, more frequently present OSA.Keywords: home mechanical ventilation, chronic obstructive pulmonary disease, noninvasive ventilation, outpatient adaptation |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|