HCFA Chronic Ventilator Demonstration

In a report by Criner et al. (28) from another HCFA Chronic Ventilator Demonstration Project Clinical Unit of 77 patients, in which 74% had medical causes, the findings were similar to Gracey s. Ninety-three percent of patients were discharged, 82% were alive at 6 months, and 61% at 12 months. Eighty-six percent of the patients were completely weaned from mechanical ventilation, 11% required continuous ventilation, and 10% had nocturnal ventilation at the time of discharge. In those discharged, there was a signifrcant increase in functional status at 5 and 12 months. 

At our facility, the Temple University Hospital, which is one of four HCFA Chronic Ventilator-Demonstration sites, the complex and diverse problems of PMV patients are treated by a diverse team comprises pulmonologists, respiratory nurses, nutritionists, psychologists, physical therapists, speech therapists, and a social worker (Fig. 2). This unit emphasizes rehabilitation and restoration of functional status despite requirements for prolonged ventilation. Special needs of patients that require PMV addressed in this unit include evaluation of the optimum form of ventilator support, special attention to swallowing dysfunction, impaired communication skills, psychological dysfunction, nutritional repletion, respiratory muscle and whole body reconditioning, as well as close attention to new or changing medical conditions. 

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