Département recherche et Développement, AGIR à dom, Meylan, France.
Faculté de Médecine, INSERM U 1042, HP2 Laboratory, Université Joseph Fourier, Grenoble, France.
Respirology. 2019 Dec;24(12):1143-1151. doi: 10.1111/resp.13497. Epub 2019 Feb 10.
Home non-invasive mechanical ventilation (NIV) has become a well-established treatment for patients with chronic hypercapnic respiratory failure. NIV monitoring has been developed to evaluate the effectiveness of mechanical ventilation on patient outcomes, with built-in systems providing data on compliance, leaks and respiratory parameters. Although these data seem intuitively useful, two main concerns have been raised in the literature: (i) are they reliable and (ii) to what extent does their use improve patient outcomes. These two concerns are currently relevant since the very recent development of telemonitoring provides the possibility of adjusting ventilator settings remotely, based on the longitudinal assessment of NIV parameters and respiratory variables provided by the system. This may influence the future management strategies of health organizations for patients under home NIV. This narrative review describes technological advances in patient monitoring using home mechanical ventilation with a main focus on data provided by built-in NIV monitoring systems. The use of these systems is discussed, including their advantages and limitations in different clinical situations, and perspectives for long-term patient monitoring are discussed.
家庭无创机械通气（NIV）已成为治疗慢性高碳酸血症性呼吸衰竭患者的成熟治疗方法。NIV 监测旨在评估机械通气对患者结局的有效性，内置系统提供关于顺应性、泄漏和呼吸参数的数据。尽管这些数据看起来直观有用，但文献中提出了两个主要关注点：（i）它们是否可靠，以及（ii）在多大程度上可以改善患者结局。这两个关注点目前很重要，因为远程监测的最新发展使得根据系统提供的 NIV 参数和呼吸变量的纵向评估，有可能远程调整呼吸机设置。这可能会影响健康组织对接受家庭 NIV 患者的未来管理策略。本叙述性综述描述了使用家庭机械通气进行患者监测的技术进步，主要重点是内置 NIV 监测系统提供的数据。讨论了这些系统的使用，包括它们在不同临床情况下的优缺点，并探讨了长期患者监测的前景。
