NIV@Home:与单日入院模型相比,在家中进行非侵入性通风启动的试点随机对照试验
Nicole L Sheers1,2,3, Liam M Hannan2,3,4, Linda Rautela2,5
1Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Australia.
Amyotrophic lateral sclerosis & frontotemporal degeneration
|October 21, 2024
概括
对于神经肌肉疾病患者来说,在家进行非侵入性通风 (NIV) 是可行的和可以接受的,尽管它需要更多的治疗师时间. 需要进行更大规模的研究来比较这种模式与传统的医院呼吸不全的启动.
科学领域:
- 肺部医学 肺部医学
- 神经学 神经学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 非侵入性通风 (NIV) 对于治疗神经肌肉疾病中的呼吸不全至关重要.
- 传统的NIV实施发生在医院,但基于远程监控的家庭模型提供了一个潜在的替代方案.
- 评估家庭内NIV启动的可行性和患者经验对于改善护理提供至关重要.
研究的目的:
- 与通常的医院护理相比,评估家庭内NIV实施模型 (NIV@Home) 的可行性,可接受性和使用情况.
- 评估12周的二次结果,包括生活质量,症状和护理人员负担.
- 通过定性采访,探索患者和护理人员对NIV@Home模型的体验.
主要方法:
- 一个单盲随机受控试验,涉及患有需要NIV的神经肌肉疾病的成年人.
- 参与者按疾病类型 (MND或其他) 和腹筋症状分层,然后随机分配到NIV@Home或Usual Care.
- 主要结局是NIV使用;次要结局包括可行性,生活质量,症状,护理者负担和质量经验.
主要成果:
- 在NIV@Home和Usual Care组之间,每日NIV使用 (>4小时/天或平均小时) 没有发现显著差异.
- 家庭内NIV实施是可行的和安全的,但需要更多的治疗师时间 (278分钟与172分钟相比).
- 在NIV@Home组的参与者报告说,在家接受护理的好处很大.
结论:
- 家庭内NIV启动是神经肌肉疾病患者的可行和可接受模式.
- 虽然需要增加治疗师的时间,但NIV@Home模型提供了患者感知的优势.
- 为了确定临床意义,与传统的医院NIV启动相比,需要进一步研究更大的样本大小.
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