Home Mechanical Ventilation and Quality of Life Measures

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


 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.


Chronic Obstructive Pulmonary Disease Amyotrophic Lateral Sclerosis Chronic Obstructive Pulmonary Disease Patient Chronic Respiratory Failure Chronic Respiratory Disease Questionnaire 

List of Abbreviations:


 amyotrophic lateral sclerosis


bilevel positive airway pressure


centimeters of water


 chronic obstructive pulmonary disease


chronic respiratory failure


chronic respiratory disease questionnaire


forced vital capacity


hospital anxiety and depression scale


home mechanical ventilation


health-related quality of life


SF-36 mental component summary


millimeters of mercury


Maugeri foundation respiratory failure item set


Nottingham health profile


neuromuscular Disease


obesity-hypoventilation syndrome


arterial carbon dioxide partial pressure


SF-36 physical component summary


sleep apnoea syndrome


MOS 36-item short-form health status survey


St. George’s respiratory questionnaire


sickness impact profile


severe respiratory insufficiency questionnaire


SRI questionnaire attendant symptoms and sleep subscale


SRI questionnaire anxiety subscale


SRI questionnaire physical functioning subscale


SRI questionnaire respiratory complaints subscale


SRI questionnaire social functioning subscale


SRI questionnaire social relationships subscale


SRI questionnaire summary scale


SRI questionnaire psychological well-being subscale




thoracic cage abnormalities


  1. AARC, Respiratory Home Care Focus Group. (2007). Respir Care. 52: 1056–1062.Google Scholar
  2. Ali S, Kabir Z. (2007). Ir Med J. 100(1): 336–338.PubMedGoogle Scholar
  3. Annane D, Orlikowski D, Chevret S, Chevrolet JC, Raphaël JC. (2007). Cochrane Database Syst Rev. 4: CD001941.PubMedGoogle Scholar
  4. Bergner M, Bobbitt RA, Carter WB, Gilson BS. (1981). Med Care. 19: 787–805.PubMedCrossRefGoogle Scholar
  5. Bergner M, Bobbitt RA, Pollard WE, Martin DP, Gilson BS. (1976). Med Care. 14: 57–67.PubMedCrossRefGoogle Scholar
  6. Bourke SC, Bullock RE, Williams TL, Shaw PJ, Gibson GJ. (2003). Neurology. 61: 171–177.PubMedGoogle Scholar
  7. Bourke SC, Tomlinson M, Williams TL, Bullock RE, Shaw PJ, Gibson GJ. (2006). Lancet Neurol. 5: 140–147.PubMedCrossRefGoogle Scholar
  8. Budweiser S, Hitzl AP, Jörres RA, Schmidbauer K, Heinemann F, Pfeifer M. (2007). Respir Res. 8: 92.PubMedCrossRefGoogle Scholar
  9. Carone M, Bertolotti G, Anchisi F, Zotti AM, Donner CF, Jones PW. (1999). Eur Respir J. 13: 1293–1300.PubMedCrossRefGoogle Scholar
  10. Cejudo P, Bautista J, Montemayor T, Villagómez R, Jiménez L, Ortega F, Campos Y, Sánchez H, Arenas J. (2005). Muscle Nerve. 32: 342–350.PubMedCrossRefGoogle Scholar
  11. Clini E, Sturani C, Rossi A, Viaggi S, Corrado A, Donner CF, Ambrosino N. Rehabilitation and Chronic Care Study Group, Italian Association of Hospital Pulmonologists (AIPO). (2002). Eur Respir J. 20: 529–538.PubMedCrossRefGoogle Scholar
  12. Chrispin PS, Scotton H, Rogers J, Lloyd D, Ridley SA. (1997). Anaesthesia. 52: 15–23.PubMedCrossRefGoogle Scholar
  13. Consensus conference. (1999). Chest. 116: 521–534.Google Scholar
  14. Doménech-Clar R, Nauffal-Manzur D, Perpiñá-Tordera M, Compte-Torrero L, Macián-Gisbert V. (2003). Respir Med. 97: 1320–1327.PubMedCrossRefGoogle Scholar
  15. Elías Hernández MT, Ortega Ruiz F, Sánchez Riera H, Otero Candelera R, Sánchez Gil R, Montemayor Rubio T. (1999). Arch Bronconeumol. 35: 261–266.PubMedGoogle Scholar
  16. Elliott MW, Simonds AK, Carroll MP, Wedzicha JA, Branthwaite MA. (1992). Thorax. 47: 342–348.PubMedCrossRefGoogle Scholar
  17. Estopá Miró R, Villasante Fernández-Montes C, de Lucas Ramos P, Ponce De León Martínez L, Mosteiro Añón M, Masa Jiménez J, Servera Pieras E, Quiroga J. (2001). Arch Bronconeumol. 37: 142–149.PubMedGoogle Scholar
  18. Euteneuer S, Windisch W, Suchi S, Köhler D, Jones PW, Schönhofer B. (2006). Respir Med. 100: 477–486.PubMedCrossRefGoogle Scholar
  19. Foglio K, Bianchi L, Bruletti G, Porta R, Vitacca M, Balbi B, Ambrosino N. (2007). Respir Med. 101: 1961–1970.PubMedCrossRefGoogle Scholar
  20. Guyatt GH, Berman LB, Townsend M, Pugsley SO, Chambers LW. (1987). Thorax. 42: 773–778.PubMedCrossRefGoogle Scholar
  21. Hunt SM, McKenna SP, McEwen J, Williams J, Papp E. (1981). Soc Sci Med [A]. 15: 221–229.Google Scholar
  22. Janssens JP, Héritier-Praz A, Carone M, Burdet L, Fitting JW, Uldry C, Tschopp JM, Rochat T. (2004). Respiration. 71: 567–574.PubMedCrossRefGoogle Scholar
  23. Janssens JP, Penalosa B, Degive C, Rabeus M, Rochat T. (1996). Monaldi Arch Chest Dis. 51: 178–184.PubMedGoogle Scholar
  24. Jones PW, Quirk FH, Baveystock CM. (1991). Respir Med. 85: 25–31.PubMedCrossRefGoogle Scholar
  25. Lenke LG, White DK, Kemp JS, Bridwell KH, Blanke KM, Engsberg JR. (2002). Spine. 27: 2041–2045.PubMedCrossRefGoogle Scholar
  26. Lloyd-Owen SJ, Donaldson GC, Ambrosino N, Escarabill J, Farre R, Fauroux B, Robert D, Schoenhofer B, Simonds AK, Wedzicha JA. (2005). Eur Respir J. 25: 1025–1031.PubMedCrossRefGoogle Scholar
  27. López A, Holgado M, Lázaro J, Olmedo C, López-Campos JL, Barrot E. (2005). Neumosur. 17: 240–245.Google Scholar
  28. López-Campos JL, Failde I, León Jiménez A, Masa Jiménez F, Barrot Cortés E, Benítez Moya JM, Ayerbe García R, Windisch W. (2006). Arch Bronconeumol. 42: 588–593.PubMedGoogle Scholar
  29. López-Campos JL, Failde I, Masa JF, Benítez-Moya JM, Barrot E, Ayerbe R, León-Jiménez A, Windisch W. (2008a). J Clin Epidemiol. 61: 1061–1066.Google Scholar
  30. López-Campos JL, Failde I, Masa JF, Benítez-Moya JM, Barrot E, Ayerbe R, León-Jiménez A. (2008b). Respir Med. 102: 605–612.Google Scholar
  31. Markström A, Sundell K, Lysdahl M, Andersson G, Schedin U, Klang B. (2002). Chest. 122: 1695–1700.PubMedCrossRefGoogle Scholar
  32. Mehta S, Hill NS. (2001). Am J Respir Crit Care Med. 163: 540–577.PubMedGoogle Scholar
  33. Narayanaswami P, Bertorini TE, Pourmand R, Horner LH. (2000). Neurorehabil Neural Repair. 14: 135–139.PubMedGoogle Scholar
  34. Nauffal D, Doménech R, Martínez García MA, Compte L, Macián V, Perpiñá M. (2002). Respir Med. 96: 777–783.PubMedCrossRefGoogle Scholar
  35. Piepers S, van den JP, Berg Kalmijn S, van der WL, Pol Wokke JH, Lindeman E, van den LH. Berg (2006). Amyotroph Lateral Scler. 7: 195–200.PubMedCrossRefGoogle Scholar
  36. Rebollo P, Bobes J, González MP, Saiz P, Ortega F. (2000). Nefrologia. 20: 171–181.PubMedGoogle Scholar
  37. Sant’ Anna CA, Stelmach R, Zanetti Feltrin MI, Filho WJ, Chiba T, Cukier A. (2003). Chest. 123: 136–141.CrossRefGoogle Scholar
  38. Simonds AK. (2003). Eur Respir J Suppl. 47: 38S–46S.PubMedCrossRefGoogle Scholar
  39. Soler JJ, Martínez-García MA, Román P, Orero R, Terrazas S, Martínez-Pechuán A. (2006). Arch Bronconeumol. 42: 501–508.PubMedGoogle Scholar
  40. Storre JH, Seuthe B, Fiechter R, Milioglou S, Dreher M, Sorichter S, Windisch W. (2006). Chest. 130: 815–821.PubMedCrossRefGoogle Scholar
  41. Testa MA, Simonson DC. (1996). N Engl J Med. 334: 835–840.PubMedCrossRefGoogle Scholar
  42. Toussaint M, Chatwin M, Soudon P. (2007). Chron Respir Dis. 4: 167–177.PubMedCrossRefGoogle Scholar
  43. Tuggey JM, Elliott MW. (2005). Thorax. 60: 859–864.PubMedCrossRefGoogle Scholar
  44. Ware JE Jr, Sherbourne CD. (1992). Med Care. 30: 473–483.PubMedCrossRefGoogle Scholar
  45. Windisch W, Budweiser S, Heinemann F, Pfeifer M, Rzehak P. (2008a). J Clin Epidemiol. 61: 848–853.Google Scholar
  46. Windisch W, Dreher M, Storre JH, Sorichter S. (2006). Respir Physiol Neurobiol. 150: 251–260.PubMedCrossRefGoogle Scholar
  47. Windisch W, Freidel K, Schucher B, Baumann H, Wiebel M, Matthys H, Petermann F. (2003a). Intensive Care Med. 29: 615–621.PubMedCrossRefGoogle Scholar
  48. Windisch W, Freidel K, Schucher B, Baumann H, Wiebel M, Matthys H, Petermann F. (2003b). J Clin Epidemiol. 56: 752–759.PubMedCrossRefGoogle Scholar
  49. Windisch W, Petermann F, Laier-Groeneveld G, Fischer S, Criée CP. (1997). Med Klin (Munich). 92: 95–100.Google Scholar
  50. Windisch W. (2008b). The “Quality of life in Home Ventilation” study group. Eur Respir J. (in press).Google Scholar
  51. Zigmond AS, Snaith RP. (1983). Acta Psychiatr Scand. 67: 361–370.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

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

There are no affiliations available

Personalised recommendations