Splaingard M L, Frates R C, Harrison G M, Carter R E, Jefferson L S
Chest. 1983 Oct;84(4):376-82. doi: 10.1378/chest.84.4.376.
We studied retrospectively 26 adults and 21 children with chronic respiratory failure whose condition was managed at home using positive-pressure ventilators in order to ascertain the outcome, benefits, and complications of this form of management. Twenty-six (55 percent) of the patients had injuries to the spinal cord. Among the 47 patients, nine were eventually weaned from the ventilator, and two died at home because of disconnection from their ventilators. Using life-table analysis, projected three-year survival was 74 percent for patients without spinal injury and 63 percent for patients with spinal injury. Mortality was greater for children than for adults. For a majority of patients, the cost of management at home was significantly less than management in the hospital, depending largely on the level of nursing care required. We suggest that mechanical ventilation at home may be a reasonable alternative to prolonged hospitalization for medically stable ventilator-dependent adults and children.
我们对26名成人和21名儿童慢性呼吸衰竭患者进行了回顾性研究，这些患者在家中使用正压呼吸机进行治疗，以确定这种治疗方式的结果、益处和并发症。26名（55%）患者有脊髓损伤。在这47名患者中，9名最终脱机，2名在家中因呼吸机脱开连接而死亡。使用寿命表分析，无脊髓损伤患者的预计三年生存率为74%，有脊髓损伤患者为63%。儿童死亡率高于成人。对于大多数患者，家庭治疗费用明显低于住院治疗，这在很大程度上取决于所需的护理水平。我们建议，对于病情稳定、依赖呼吸机的成人和儿童，家庭机械通气可能是长期住院的合理替代方案。
