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Home Mechanical Ventilation and Quality of Life Measures

  • J. L. López-Campos
  • W. Windisch
  • I. Failde
Reference work entry

Abstract:

 Home mechanical ventilation (HMV) is a mode of ventilatory support for the treatment of  chronic respiratory failure (CRF) which is carried out in the home of the patient.  Ventilator-assisted individuals are composed of a mix of adult and pediatric patients with a variety of underlying medical conditions contributing to CRF. Current evidence about the therapeutic benefit of HMV is consistent, producing the alleviation of the symptoms of chronic  hypoventilation. As a consequence, HMV improves health-related quality of life (HRQL) in patients with chronic hypoventilation. This effect is maintained over time and is influenced by the progression of the disease among other factors. Although several generic or COPD-specific questionnaires used for HMV patients are available, the application of these questionnaires in HMV patients is problematic, as these questionnaires do not specifically target HRQL impairments that result from CRF. Accordingly, the need for adequate evaluation of HRQL in HMV patients has been addressed by the development of two condition-specific questionnaires, Maugeri Foundation Respiratory Failure item set (MRF-28) and the Severe Respiratory Insufficiency (SRI) Questionnaire. The MRF-28 is valid for patients with CRF due to COPD or  kyphoscoliosis, but somewhat unspecific with regard to the treatment modality, since not only HMV patients, but also those with  long-term oxygen therapy alone have been included in the validation study. In contrast, the SRI is highly valid for patients receiving  non-invasive HMV. Factors independently associated with HRQL in HMV patients are dyspnea, an obstructive pattern in pulmonary function tests, and the number of hospitalizations in the previous year. In addition, the underlying disease has been shown to significantly impact on HRQL with patients suffering from restrictive thoracic disorders, particularly those with kyphoscoliosis, reporting best HRQL. Other limiting factors such as the use of long-term oxygen therapy, number of hours of ventilation and type of mask are also suggested to influence HRQL perception in HMV patients.

Keywords

Chronic Obstructive Pulmonary Disease Amyotrophic Lateral Sclerosis Chronic Obstructive Pulmonary Disease Patient Chronic Respiratory Failure Chronic Respiratory Disease Questionnaire 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:

ALS

 amyotrophic lateral sclerosis

BIPAP

bilevel positive airway pressure

cmH2O

centimeters of water

COPD

 chronic obstructive pulmonary disease

CRF

chronic respiratory failure

CRQ

chronic respiratory disease questionnaire

FVC

forced vital capacity

HAD

hospital anxiety and depression scale

HMV

home mechanical ventilation

HRQL

health-related quality of life

MCS

SF-36 mental component summary

mmHg

millimeters of mercury

MRF-28

Maugeri foundation respiratory failure item set

NHP

Nottingham health profile

NMD

neuromuscular Disease

OHS

obesity-hypoventilation syndrome

PaCO2

arterial carbon dioxide partial pressure

PCS

SF-36 physical component summary

SAS

sleep apnoea syndrome

SF-36

MOS 36-item short-form health status survey

SGRQ

St. George’s respiratory questionnaire

SIP

sickness impact profile

SRI

severe respiratory insufficiency questionnaire

SRI-AS

SRI questionnaire attendant symptoms and sleep subscale

SRI-AX

SRI questionnaire anxiety subscale

SRI-PF

SRI questionnaire physical functioning subscale

SRI-RC

SRI questionnaire respiratory complaints subscale

SRI-SF

SRI questionnaire social functioning subscale

SRI-SR

SRI questionnaire social relationships subscale

SRI-SS

SRI questionnaire summary scale

SRI-WB

SRI questionnaire psychological well-being subscale

TBC

tuberculosis

TCA

thoracic cage abnormalities

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Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • J. L. López-Campos
  • W. Windisch
  • I. Failde

There are no affiliations available

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