Where to perform long-term ventilation

Given that most VAI prefer to be cared for at home and that their return home is the desire of families, health care professionals, and others concerned with LTMV, the effort to transform prolonged mechanical ventilation from a hospital-centered to a home-centered treatment needs to be continued and further developed. Nevertheless, the future of high-technology home care will undoubtedly be influenced by improvements in quality and containment of costs, as in its current status treatment of VAI at home too often leads to family disruption and presents a dramatically increasing cost burden. Careful selection of patients, closer attention to education and training, and collection of outcome data are all factors that presumably will facilitate the development of better-quality and cost-saving home care.