Home-based monitorization of neuromuscular patients with non-invasive ventilation: implementation of a patient-centered protocol

2019 ◽  
Author(s):  
Rui Vilarinho ◽  
Teresa Magalhães ◽  
Cláudia Maciel ◽  
Joana Sampaio-Silva ◽  
Cátia Esteves ◽  
...  
Keyword(s):  
Invasive Ventilation ◽  
Patient Centered ◽  
Non Invasive ◽  
Home Based ◽  
Non Invasive Ventilation

scholarly journals Home-Based Adaptation to Night-time Non-invasive Ventilation in Patients With Amyotrophic Lateral Sclerosis: A Randomised Controlled Trial Running Head: Home Adaptation to Non-invasive Ventilation in Amyotrophic Lateral Sclerosis

2021 ◽  
Author(s):  
Eleonora Volpato ◽  
Michele Vitacca ◽  
Luciana Ptacinsky ◽  
Agata Lax ◽  
Salvatore D'Ascenzo ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Caregiver Burden ◽  
Outpatient Setting ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Home Based ◽  
Non Invasive Ventilation ◽  
Sf 36 ◽  
Lateral Sclerosis

Abstract Background: Adaptation to Non-Invasive Ventilation (NIV) in Amyotrophic Lateral Sclerosis (ALS) is generally implemented in an inpatient or outpatient setting.Aims: To investigate whether adaptation to home-based NIV is as effective as outpatient one in ALS in terms of arterial carbon dioxide (PaCO2) improvement. We also evaluated as secondary outcomes NIV acceptance, adherence and patient/caregiver satisfaction, quality of life (QoL) and caregiver burden.Methods: Sixty-six ALS patients with indication for NIV were randomly assigned to two groups: 34 underwent NIV initiation at home (Home Adaptation, HA) and 32 at multiple outpatient visits (Outpatient Adaptation, OA). Respiratory function tests were performed at baseline (T0) together with blood gas analysis, which was repeated at the end of adaptation (T1) and after 2 and 6 months from T1. Overnight cardiorespiratory polygraphy was performed at T0, T2, and T3. NIV acceptance (≥5 hours/night for 3 consecutive nights) and patient's and caregiver's expertise to manage NIV by an educational learning test were measured at T1; NIV adherence (≥150 hours/month) was measured at T2 and T3. Short Form Health Survey (SF-36), Caregiver burden Inventory (CBI), Caregiver burden scale (CBS) and Zarit Burden Interview (ZBI) were performed at T0, T2 and T3.Results: Fifty-eight participants completed the study. No significant differences were found between groups in PaCO2 at T1 (p=0.46), T2 (p=0.50) and T3 (p=0.34) as in acceptance (p=0.55) and adherence to NIV at T2 and T3 (p=0.60 and p=0.75, respectively). At T2, the patients’ QoL, assessed with SF-36, was significantly better in HA than OA (p=0.01), but this improvement was not maintained up to T3 (p = 0.17). Conclusions: In ALS, adaptation to NIV in the patient’s home is effective as that performed in an outpatient setting, in terms of PaCO2 , acceptance and adherence. Improvement in quality of life was also found to be greater at home only after adaptation, opening the need for further studies to understand the role of environment with respect to NIV adherence.

Non-invasive ventilation in palliative care: a systematic review

2020 ◽  
Vol 110 (6) ◽  
Author(s):  
Teresa Diaz de Teran ◽  
Elena Barbagelata ◽  
Catia Cilloniz ◽  
Antonello Nicolini ◽  
Tommaso Perazzo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation
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