Department of Respiratory Diseases, Clínica Dávila, Recoleta 464, Building H, 6th floor, Santiago, Chile.
Ministry of Health, AVNIA-AVIA Programs, Santiago, Chile.
BMC Pulm Med. 2021 Dec 2;21(1):394. doi: 10.1186/s12890-021-01764-4.
Home mechanical ventilation (HMV) is a viable and effective strategy for patients with chronic respiratory failure (CRF). The Chilean Ministry of Health started a program for adults in 2008.
This study examined the following data from a prospective cohort of patients with CRF admitted to the national HMV program: characteristics, mode of admission, quality of life, time in the program and survival.
A total of 1105 patients were included. The median age was 59 years (44-58). Women accounted for 58.1% of the sample. The average body mass index (BMI) was 34.9 (26-46) kg/m. A total of 76.2% of patients started HMV in the stable chronic mode, while 23.8% initiated HMV in the acute mode. A total of 99 patients were transferred from the children's program. There were 1047 patients on non-invasive ventilation and 58 patients on invasive ventilation. The median baseline PaCO level was 58.2 (52-65) mmHg. The device usage time was 7.3 h/d (5.8-8.8), and the time in HMV was 21.6 (12.2-49.5) months. The diagnoses were COPD (35%), obesity hypoventilation syndrome (OHS; 23.9%), neuromuscular disease (NMD; 16.3%), non-cystic fibrosis bronchiectasis or tuberculosis (non-CF BC or TBC; 8.3%), scoliosis (5.9%) and amyotrophic lateral sclerosis (ALS; 5.24%). The baseline score on the Severe Respiratory Insufficiency questionnaire (SRI) was 47 (± 17.9) points and significantly improved over time. The lowest 1- and 3-year survival rates were observed in the ALS group, and the lowest 9-year survival rate was observed in the non-CF BC or TB and COPD groups. The best survival rates at 9 years were OHS, scoliosis and NMD. In 2017, there were 701 patients in the children's program and 722 in the adult´s program, with a prevalence of 10.4 per 100,000 inhabitants.
The most common diagnoses were COPD and OHS. The best survival was observed in patients with OHS, scoliosis and NMD. The SRI score improved significantly in the follow-up of patients with HMV. The prevalence of HMV was 10.4 per 100,000 inhabitants. Trial registration This study was approved by and registered at the ethics committee of North Metropolitan Health Service of Santiago, Chile (N° 018/2021).
家庭机械通气（HMV）是慢性呼吸衰竭（CRF）患者的可行且有效的策略。智利卫生部于 2008 年开始为成年人启动了一项计划。
本研究从国家 HMV 计划收治的 CRF 患者前瞻性队列中检查了以下数据：特征、入院方式、生活质量、在该计划中的时间和生存情况。
共纳入 1105 例患者。中位年龄为 59 岁（44-58）。女性占样本的 58.1%。平均体重指数（BMI）为 34.9（26-46）kg/m。76.2%的患者以稳定的慢性模式开始 HMV，23.8%的患者以急性模式开始 HMV。共有 99 例患者从儿科计划转来。有 1047 例患者接受无创通气，58 例患者接受有创通气。基线 PaCO 水平中位数为 58.2（52-65）mmHg。设备使用时间为 7.3 小时/天（5.8-8.8），HMV 时间为 21.6（12.2-49.5）个月。诊断为 COPD（35%）、肥胖低通气综合征（OHS；23.9%）、神经肌肉疾病（NMD；16.3%）、非囊性纤维化支气管扩张或结核病（非 CF BC 或 TBC；8.3%）、脊柱侧凸（5.9%）和肌萎缩侧索硬化症（ALS；5.24%）。基线严重呼吸不足问卷（SRI）评分 47（±17.9）分，随时间显著改善。ALS 组最低的 1 年和 3 年生存率，非 CF BC 或 TBC 和 COPD 组最低的 9 年生存率。9 年时最佳生存率见于 OHS、脊柱侧凸和 NMD 组。2017 年，儿科计划中有 701 例患者，成人计划中有 722 例患者，患病率为每 10 万人 10.4 例。
最常见的诊断是 COPD 和 OHS。OHS、脊柱侧凸和 NMD 患者的生存情况最佳。HMV 患者的 SRI 评分在随访中显著改善。HMV 的患病率为每 10 万人 10.4 例。
本研究经智利圣地亚哥北都市卫生服务伦理委员会批准并在该委员会注册（编号 018/2021）。
