Chest
Clinicai Investigations: Important TopicsFrequency, Causes, and Outcome of Home Ventilator Failure
Section snippets
Materials and Methods
All patients who were receiving ventilator assistance at home, including children and adults, served by the Greater Los Angeles Branch of National Medical Homecare (NMC; Pasadena, CA) were included. The total number of patients served in the area were 150 children and adults with chronic respiratory failure who received a total of 841,234 h of assisted ventilation (average 5,608 h per ventilator assisted patient; or 15.4 h/d per ventilator-assisted patient). They ranged in age from 2 to 77
Results
There were a total of 189 cases of suspected ventilator failure reported to NMC during the year for 841,234 h of assisted ventilation (1 failure for every 1.25 years of continuous ventilator use). Of the 95 male patients receiving assisted ventilation, failures were reported in 57 (60%) as compared with 30 of 55 female patients (54%); p = 0.32, not significant. There were no significant differences in the proportion of patients reporting ventilator failures at different ages (Table 1).
Of the 69
Discussion
Our study showed that home ventilator failure occurred relatively infrequently in a population of 150 patients requiring home mechanical ventilation. Further, equipment failure was not a frequent or serious problem for these ventilator-assisted patients treated at home. In a 1-year period of time, there were a total of 189 reports of home ventilator failure in 150 patients. Ventilator failures were reported in patients of all age groups and in both sexes. There were no adverse outcomes from
ACKNOWLEDGMENTS
The authors thank the NMC Respiratory Therapists, Renee Moreno, RCP, Nadine Antunez, RCP, Joyce Moga, RCP, and Armando Rave, RCP, for completing ventilator failure reports for this study. We thank Ron Chamberlain for writing the computer program used to compile and analyze these data.
References (11)
- et al.
Medical and psychosocial outcome of children with congenital central hypoventilation syndrome
J Pediatr
(1991) - et al.
Long term ventilatory support in spinal muscular atrophy
J Pediatr
(1989) - et al.
Long-term mechanical ventilation: guidelines for management in the home and at alternate community sites: report of the ad hoc committee, Respiratory Care Section, American College of Chest Physicians
Chest
(1986) - et al.
Surveys of long-term ventilatory support in Minnesota: 1986 and 1992
Chest
(1993) - et al.
Home mechanical ventilation: demographics and user perspectives
Chest
(1995)
Cited by (60)
Predictors of early hospital readmission in patients receiving home mechanical ventilation
2023, Heart and LungCitation Excerpt :These results suggest that HMV helps reduce the frequency of acute exacerbations in patients with chronic lung disease. Srinivasan et al.5 reported that 39% of the patients who were visited at home by the vendor for ventilator dysfunction had operational problems; however, most issues were resolved at home without any side effects. Only two patients required hospitalization because of care-related patient factors not due to a defect in the equipment.
Severe adverse events in children with tracheostomy and home mechanical ventilation - Comparison of pediatric home care and a specialized pediatric nursing care facility
2022, Respiratory MedicineCitation Excerpt :Respirator equipment failure was not a frequent or serious problem during the entire observation period. These results confirm previous data from Srinivasan et al., who reported no serious ventilator-associated incident occurred in their study with 150 patients on HMV [25]. On average knowledge of caregivers about ventilators and the handling of emergencies was rated as good [26].
Mortality outcomes of patients on chronic mechanical ventilation in different care settings: A systematic review
2021, HeliyonCitation Excerpt :Although the reason is unclear, this suggests that ventilator care, albeit daunting and seemingly complex, can safely occur outside centralized health care institutions. Indeed, our systematic review underscores that ventilator failure is rarely the cause of death for patients on home mechanical ventilation [77] and there is no increased risk of hospitalizations as a result of home mechanical ventilation [13, 21, 39, 61, 63]. Our study illustrates the safety of providing ventilatory care in settings outside the intensive care unit, more than two decades after the release of the consensus statement on “Mechanical Ventilation Beyond the Intensive Care Unit.” [11]
Children Dependent on Respiratory Technology
2019, Kendig's Disorders of the Respiratory Tract in ChildrenChildren Dependent on Respiratory Technology
2012, Kendig and Chernick's Disorders of the Respiratory Tract in ChildrenOutcomes of home mechanical ventilation with tracheostomy after congenital heart surgery
2021, Cardiology in the Young