Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada.
Chron Respir Dis. 2023 Jan-Dec;20:14799731231176301. doi: 10.1177/14799731231176301.
Individuals dependent on long-term mechanical ventilation (LTMV) for their day-to-day living are a heterogenous population who go through several transitions over their lifetime. This paper describes three transitions: 1) institution/hospital to community/home, 2) pediatric to adult care, and 3) active treatment to end-of-life for ventilator-assisted individuals (VAIs).
A narrative review based on literature and the author's collective practical and research experience. Four online databases were searched for relevant articles. A manual search for additional articles was completed and the results are summarized.
Transitions from hospital to home, pediatric to adult care, and to end-of-life for VAIs are complex and challenging processes. Although there are several LTMV clinical practice guidelines highlighting key components for successful transition, there still exists gaps and inconsistencies in care. Most of the literature and experiences reported to date have been in developed countries or geographic areas with funded healthcare systems.
For successful transitions, the VAIs and their support network must be front-and-center. There should be a coordinated, systematic, and holistic plan (including a multi-disciplinary team), life-time follow-up, with bespoke consideration of jurisdiction and individual circumstances.
长期依赖机械通气（LTMV）维持日常生活的患者是一个异质群体，他们在一生中会经历多次过渡。本文描述了三种过渡：1）机构/医院到社区/家庭，2）儿科到成人护理，以及 3）有创通气患者从积极治疗到生命终末期。
基于文献和作者集体实践和研究经验的叙述性综述。在四个在线数据库中搜索相关文章。并完成了对其他文章的手动搜索，总结了结果。
从医院到家庭、从儿科到成人护理以及有创通气患者的生命终末期的过渡是复杂且具有挑战性的过程。尽管有几个 LTMV 临床实践指南强调了成功过渡的关键组成部分，但护理仍存在差距和不一致。迄今为止，大多数文献和经验报告都来自发达国家或有资金支持的医疗保健系统的地理区域。
为了实现成功过渡，必须将有创通气患者及其支持网络置于核心位置。应该有一个协调、系统和整体的计划（包括多学科团队）、终身随访，并根据管辖范围和个人情况进行专门考虑。
