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[Home mechanical ventilation: the extra-hospital phase].

M Antonelli1, G Conti, M A Pennisi

  • 1Università Cattolica del Sacro Cuore, Istituto di Anestesiologia e Rianimazione, Policlinico A. Gemelli, Roma. max.antonelli@flashnet.it

Minerva Anestesiologica
|March 10, 2001
PubMed
Summary

Home mechanical ventilation is a key option for patients unable to wean from ventilatory support. Advances in non-invasive interfaces and positive pressure ventilators are improving accessibility, though multidisciplinary support remains a challenge.

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Area of Science:

  • Pulmonary Medicine
  • Critical Care Medicine

Context:

  • Home mechanical ventilation (HMV) is increasingly utilized for patients with chronic respiratory failure.
  • Positive pressure ventilators have become more reliable, user-friendly, and portable, facilitating HMV adoption.
  • Tracheostomy and non-invasive interfaces (nasal/oral masks) are primary patient/ventilator interfaces for HMV.

Purpose:

  • To review the indications, interfaces, and challenges of home mechanical ventilation.
  • To present the experience of Policlinico Universtitario "La Sapienza", Rome with HMV.

Summary:

  • HMV is indicated when complete weaning from ventilatory support is impossible, provided no medical or socio-economic contraindications exist.
  • Tracheostomy is preferred for patients with significantly reduced spontaneous ventilatory ability, while improved non-invasive masks serve other patients.

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  • A significant limitation to HMV is the current lack of integrated multidisciplinary territorial support structures.
  • Impact:

    • HMV offers a viable alternative to prolonged hospitalization for select patients.
    • Technological advancements are expanding the reach and efficacy of HMV.
    • Addressing the need for comprehensive multidisciplinary support is crucial for optimizing HMV outcomes.