Mechanical ventilation long-term

Long-Term Mechanical Ventilation, edited by N. S. Hill... 

Other home care programs with smaller pharmacist implications are long-term mechanical ventilation and... 

O Donohue WJ Jr., Giovannoni RM, Goldberg AF, et al. Long-term mechanical ventilation guidelines for management in the home and alternate community sites. Chest 1986 90 1S-37S. 

Tafreshi M, Schneider R, Rosen M. Outcome of patients who require long-term mechanical ventilation and hemodialysis (abstract). Chest 1995 108(suppl) 134S. 

Schonhofer B, Guo JJ, Suchi S, et al. The use of APACHE II prognostic system in difficult-to-wean patients after long-term mechanical ventilation. Eur J Anaesthesiol 2004 21(7) 558-565. 

Gluck EH. Predicting eventual success or failure to wean in patients receiving long-term mechanical ventilation. Chest 1996 110(4) 1018-1024. 

Each year, over 400,000 patients in the United States receive mechanical ventilation as a result of acute or acute-on-chronic respiratory failure (1,2). About a quarter of acutely ventilated patients repeatedly fail attempts at weaning and may require prolonged mechanical ventilation (PMV) (Fig. 1) (3,4). The proportion of patients experiencing PMV ranges between 0% and 20% (5-13). Out of patients who survive PMV, 9-66% become dependent on long-term mechanical ventilation (LTMV) (4,9,14-21). Two factors account for these wide variations in the outcome. The first factor is differences in patient population. The second one is the nosology of what constitutes PMV and what constitutes LTMV is unsatisfactory. 

Purro A, Appendini L, De Gaetano A, et al. Physiologic determinants of ventilator dependence in long-term mechanically ventilated patients. Am J Respir Crit Care Med 2000 161(4 pt 1) 1115-1123. 

Pierson DJ. Long-term mechanical ventilation and weaning. Respir Care 1995 40 289-295. 

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Ceriana P, Carlucci A, Navalesi P, et al. Weaning from tracheotomy in long-term mechanically ventilated patients feasibility of a decisional flowchart and clinical outcome. Intensive Care Med 2003 29 845-848. 

Many of the rehabilitation strategies for critically ill patients are organized in facilities for long-term mechanical ventilation (LTMV) or within specialized respiratory ICUs. Patients are transferred to these facilities when their LOS in ICU exceeds a set criterion (often 21 days) or when the patient is perceived as difficult to wean. Several investigators have... 

Long-term mechanical ventilation (LTMV) has existed for over 50 years, with polio survivors of the mid-20th century representing the first generation of ventilator-assisted individuals (VAIs) (1). LTMV was initially conceived as a hospital-centered treatment, and intensive care units (ICU) remained the primary sites for treatment of most of the long-term VAIs until the end of the 1980s (2,3). 

Figure 1 Kindred Admission Screening Tool (KAST) client reports. Source-. From Ref. 35. Table 3 Characteristics of Alternative Site of Care for Long-Term Mechanical Ventilation...

Long-term mechanical ventilation (LTMV) in the home setting is a very rewarding challenge for the clinically stable patient, the health care team and the caregivers (4). 

Cuvelier A, Grigoriu B, Molano LC, et al. Limitations of transcutaneous carbon dioxide measurements for assessing long-term mechanical ventilation. Chest 2005 127 1744-1748. Heuss LT, Chhajed PN, Schnieper P, et al. Combined pulse oximetry/cutaneous carbon dioxide tension monitoring during colonoscopies pilot study with a smart ear clip. Digestion 2004 ... 

Euteneuer S, Windisch W, Suchi S, et al. Health-related quality of life in patients with chronic respiratoiy failure after long-term mechanical ventilation. Respir Med 2006 100(3) 477-486. 

In patients with chronic respiratory failure where long-term mechanical ventilation is a feasible option, early identification and a full explanation with active patient participation of all possible options is essential. Patients can then be assisted in making informed choices, and be supported in these choices by their families and their clinical teams. 

Cazzolli PA, Oppenheimer EA. Home mechanical ventilation for motor neuron disease (MND/ ALS) nasal compared to tracheostomy intermittent positive pressure ventilation (IPPV). Abstracts of Papers, 6th Intemational Symposium on ALS/MND, Dublin, Ireland, November 17-19, 1995. Moss AH, Oppenheimer EA, Casey P, et al. Patients with amyotrophic lateral sclerosis receiving long-term mechanical ventilation advance care planning and outcomes. Chest 1996 110 249-255. 

C. Long-Term Mechanical Ventilation a U.K. Nursing Perspective... 

Figure 1 Three-stage weaning pathway to identify who are the LTMV patients. Abbreviation LTMV, long-term mechanical ventilation.

Nozawa E, Kobayashi E, Matsumoto ME, et al. Assessment of factors that influence weaning from long-term mechanical ventilation after cardiac surgery. Arq Bras Cardiol 2003 80 306-310. 

Tatara K, Ishikawa Y, Imai T, et al. A study on effective, efficient, and safe management of long-term mechanical ventilation. A 2005 collaborative research report of the National Organization Hospital [in Japanese]. 2006 (in press). 

Trends in the increasing number of patients requiring long-term mechanical ventilation (LMV) are universal, with no exceptions in the Asia Pacific area. Patient characteristics and clinical outcomes are essentially the same as those in the industrialized countries (1,2). Because of the iiiherent diversity of cultures and socioeconomic status, the Asia Pacific area has its unique issues to address regarding health services and the medical ethics of LMV. In this chapter, we will illustrate some of these issues, as they are experienced in Taiwan and we will highlight some of the challenges that they present. 

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