Home mechanical ventilation

Abstract

BACKGROUND: Home care provided by the Łódź Hospice for Children increases the patients' feeling of security and improves their quality of life. METHODS: The program provides free, around-the-clock, holistic care within a radius of 120 km, in cooperation with the University Hospital. The model of care has been based on the WHO program of home hospitalization. RESULTS: Between 1999 and 2006, 34 paediatric and adult patients, of both sexes (20.6% females, 79.4% males), aged 8 months to 48 years, received home mechanical lungs ventilation. The underlying causes of respiratory failure were neuromuscular pathologies (82.4%), central nervous system disorders (14.7%) and kyphoscoliosis (2.9%). Nineteen (55.9%) patients were children. Seven patients (20.6%) were ventilated invasively, and 27(79.4%), including three infants with spinal muscular atrophy, were ventilated noninvasively. Home lungs ventilation was provided for from 7 to 3089 days. Eight (23.5%) patients, four from each group (invasive vs noninvasive ventilation), died--five in a hospital and three at home. The causes of death were respiratory accident (2) or acute respiratory infection (6). CONCLUSIONS: Our seven-year experience proves that home ventilation can be accepted by patients and their families and can be provided even in infancy. The presented model of care was highly valued by patients.