Home Mechanical Ventilation: a Narrative Review and a Proposal of Practical Approach

Overview

Journal Braz J Anesthesiol

Date 2025 Jan 27

PMID 39870323

Authors

Simone Chaves Fagondes

Carmem Lucia Oliveira da Silva

Anneliese Hoffmann

Rita de Cassia Guedes de Azevedo Barbosa

Daiane Falkembach

Angela Beatriz John

Affiliations

Soon will be listed here.

Abstract

Growing evidence of the benefits of home ventilatory support in patients with chronic respiratory failure along with technological advances in ventilators have enabled their use in overly complex situations, shaping a new scenario for physicians. This has further given rise to new challenges related to their incorporation into current medical practice. However, this evolution needs to be coupled with knowledge and skills of physicians who are willing to prescribe Home Mechanical Ventilation (HMV), in order to prevent them from making inappropriate choices or adjustments that may ultimately have ethical and legal implications. This article aims to provide guidance and information to support the indication for HMV and the ventilation modalities to be implemented, review basic ventilation concepts, including the ventilator modes most commonly used in patients outside the hospital setting, list the brands and models available in the Brazilian market, provide the means for obtaining equipment for HMV, and finally, describe the requirements for selection of equipment, taking into account the individual characteristics of the patient to ensure safe perioperative care and earlier dehospitalization.

References

Kwiatosz-Muc M, Kopacz B, Fijalkowska-Nestorowicz A . Quality of Life and Stress Levels in Patients under Home Mechanical Ventilation: What Can We Do to Improve Functioning Patients at Home? A Survey Study. Int J Environ Res Public Health. 2023; 20(1). PMC: 9820158. DOI: 10.3390/ijerph20010874. View

Bonvento B, Wallace S, Lynch J, Coe B, McGrath B . Role of the multidisciplinary team in the care of the tracheostomy patient. J Multidiscip Healthc. 2017; 10:391-398. PMC: 5644554. DOI: 10.2147/JMDH.S118419. View

Park S, Suh E . Home mechanical ventilation: back to basics. Acute Crit Care. 2020; 35(3):131-141. PMC: 7483009. DOI: 10.4266/acc.2020.00514. View

Ergan B, Oczkowski S, Rochwerg B, Carlucci A, Chatwin M, Clini E . European Respiratory Society guidelines on long-term home non-invasive ventilation for management of COPD. Eur Respir J. 2019; 54(3). DOI: 10.1183/13993003.01003-2019. View

Evans R, Catapano M, Brooks D, Goldstein R, Avendano M . Family caregiver perspectives on caring for ventilator-assisted individuals at home. Can Respir J. 2012; 19(6):373-9. PMC: 3603762. DOI: 10.1155/2012/452898. View

Sterni L, Collaco J, Baker C, Carroll J, Sharma G, Brozek J . An Official American Thoracic Society Clinical Practice Guideline: Pediatric Chronic Home Invasive Ventilation. Am J Respir Crit Care Med. 2016; 193(8):e16-35. PMC: 5439679. DOI: 10.1164/rccm.201602-0276ST. View

Amaddeo A, Frapin A, Fauroux B . Long-term non-invasive ventilation in children. Lancet Respir Med. 2016; 4(12):999-1008. DOI: 10.1016/S2213-2600(16)30151-5. View

van den Biggelaar R, Hazenberg A, Cobben N, Gommers D, Gaytant M, Wijkstra P . Home mechanical ventilation: the Dutch approach. Pulmonology. 2021; 28(2):99-104. DOI: 10.1016/j.pulmoe.2021.11.001. View

Macrea M, Oczkowski S, Rochwerg B, Branson R, Celli B, Coleman 3rd J . Long-Term Noninvasive Ventilation in Chronic Stable Hypercapnic Chronic Obstructive Pulmonary Disease. An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med. 2020; 202(4):e74-e87. PMC: 7427384. DOI: 10.1164/rccm.202006-2382ST. View

10.

Plaszewska-Zywko L, Fajfer-Gryz I, Cichon J, Kozka M . Burden, social support, and coping strategies in family caregivers of individuals receiving home mechanical ventilation: a cross-sectional study. BMC Nurs. 2024; 23(1):346. PMC: 11110424. DOI: 10.1186/s12912-024-02024-6. View

11.

Ortenblad L, Carstensen K, Vaeggemose U, Lovschall C, Sprehn M, Kuchen S . Users' Experiences With Home Mechanical Ventilation: A Review of Qualitative Studies. Respir Care. 2019; 64(9):1157-1168. DOI: 10.4187/respcare.06855. View

12.

Hess D . Noninvasive ventilation for acute respiratory failure. Respir Care. 2013; 58(6):950-72. DOI: 10.4187/respcare.02319. View

13.

Bello G, De Pascale G, Antonelli M . Noninvasive Ventilation. Clin Chest Med. 2016; 37(4):711-721. DOI: 10.1016/j.ccm.2016.07.011. View

14.

Schwarz E, Mackie M, Weston N, Tincknell L, Beghal G, Cheng M . Time-to-death in chronic respiratory failure on home mechanical ventilation: A cohort study. Respir Med. 2020; 162:105877. DOI: 10.1016/j.rmed.2020.105877. View

15.

Schafer H . [Home mechanical ventilation]. MMW Fortschr Med. 2020; 162(7):41-50. PMC: 7155153. DOI: 10.1007/s15006-020-0012-z. View

16.

Cantero C, Adler D, Pasquina P, Uldry C, Egger B, Prella M . Long-Term Noninvasive Ventilation in the Geneva Lake Area: Indications, Prevalence, and Modalities. Chest. 2020; 158(1):279-291. DOI: 10.1016/j.chest.2020.02.064. View

17.

Pallero M, Puy C, Guell R, Pontes C, Marti S, Torres F . Ambulatory adaptation to noninvasive ventilation in restrictive pulmonary disease: a randomized trial with cost assessment. Respir Med. 2014; 108(7):1014-22. DOI: 10.1016/j.rmed.2014.04.016. View

18.

Chawla J, Edwards E, Griffiths A, Nixon G, Suresh S, Twiss J . Ventilatory support at home for children: A joint position paper from the Thoracic Society of Australia and New Zealand/Australasian Sleep Association. Respirology. 2021; 26(10):920-937. PMC: 9291882. DOI: 10.1111/resp.14121. View

19.

Duiverman M . "Tricks and tips for home mechanical ventilation" Home mechanical ventilation: set-up and monitoring protocols. Pulmonology. 2020; 27(2):144-150. DOI: 10.1016/j.pulmoe.2020.08.002. View

20.

Dale C, King J, Nonoyama M, Carbone S, McKim D, Road J . Transitions to Home Mechanical Ventilation: The Experiences of Canadian Ventilator-Assisted Adults and Their Family Caregivers. Ann Am Thorac Soc. 2017; 15(3):357-364. DOI: 10.1513/AnnalsATS.201708-663OC. View