Domiciliary ventilation

Patients receiving IPPV represent a small fraction of the patients receiving domiciliary ventilation. In a recent European survey, they comprised 13% of those ventilated at home, representing 24%, 8%, and 5%, respectively, of patients with neuromuscular disease (NMD), parenchymal disease, and RTD, respectively (9). Selection and management of tracheostomy tubes for IPPV must maximize the patients ability to speak and swallow (7). 

Fauroux B, Pigeot J, Isabey D, et al. In vivo physiological comparison of two ventilators used for domiciliary ventilation in children with cystic fiteosis. Crit Care Med 2001 29 2097-2105. 

Chailleux E, Fauroux B, Binet F, et al. Predictors of survival in patients receiving domiciliary oxygen therapy or mechanical ventilation. A 10-year analysis of ANTADIR observatory. Chest 1996 109 741-749. 

Piper et al. (157) used domiciliary NIV for up to 18 months in four CF patients with chronic ventilatory failure who had failed to respond to optimal conventional measures. Using a volume-cycled ventilator, their Pac02 fell, sleep quality improved, and RMS increased. This may suggest at least a stabilizing effect. 

Simonds AK, Elliott MW. Outcome of domiciliary nasal intermittent positive pressure ventilation in restrictive and obstructive disorders. Thorax 1995 50(6) 604-609. 

Elliott MW, Simonds AK, Carroll MP, et al. Domiciliary nocturnal nasal intermittent positive pressure ventilation in hypercapnic respiratory failure due to chronic obstructive lung disease effects on sleep and quality of life. Thorax 1992 47(5) 342-348. 

Jones SE, Packham S, Hebden M, et al. Domiciliary nocturnal intermittent positive pressure ventilation in patients with respiratory failure due to severe COPD long-term follow up and effect on survival. Thorax. 1998 53 495-498. 

Tuggey JM, Plant PK, Elliott MW. Domiciliary non-invasive ventilation for recurrent acidotic exacerbations of COPD an economic analysis. Thorax 2003 58 867-871. 

Nett LM, Obrigewith R. Home visiting system and improved quality of life. In Kira S, Petty TL, eds. Progress in Domiciliary Respiratory Care. Amsterdam Excerpta Medica, 1994. Lloyd-Owen SJ, Donaldson GC, Ambrosino N, et al. Patterns of home mechanical ventilation use in Europe results from the Eurovent survey. Eur Respir J 2005 25 1025-1031. 

Table 2 Training Plan for Domiciliary Mechanical Ventilation Items...

Perrin C, El Far Y, Vandenbos F, et al. Domiciliary nasal intermittent positive pressure ventilation in severe COPD effects on lung function and quality of life. Eur Respir J 1997 10 2835-2839. 

Figure 1 Rate of use of three different noninvasive interfaces (oro-nasal mask, nasal mask, nasal pillows), as reported by the studies where noninvasive ventilation was utilized to treat acute left) and chronic (right) patients. The oro-nasal mask is the interface of choice in patients with acute or acute on chronic ventilatory failure, while it is less commonly employed for domiciliary treatment of stable chrcniic ventilatory failure. The nasal mask is preferred for long-term treatment of chronic patients. Source From Refs. 39 and 40.

Simonds AK, Ward S, Heather S, et al. Outcome of paediatric domiciliary mask ventilation in neuromuscular and skeletal disease. Eur Respir J 2000 16 476-481. 

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