International Survey of the Tools Used for Assessment, Monitoring and Management of Home Mechanical Ventilation Patients
Background: There are limited data reporting diagnostic practices, compared to clinical guidelines, for patients with chronic respiratory failure requiring home mechanical ventilation (HMV). There are no data detailing the current use of downloaded physiological monitoring data in day-to-day clinica...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/21/6803 |
| _version_ | 1797631712155402240 |
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| author | Michelle Chatwin Nicholas Hart |
| author_facet | Michelle Chatwin Nicholas Hart |
| author_sort | Michelle Chatwin |
| collection | DOAJ |
| description | Background: There are limited data reporting diagnostic practices, compared to clinical guidelines, for patients with chronic respiratory failure requiring home mechanical ventilation (HMV). There are no data detailing the current use of downloaded physiological monitoring data in day-to-day clinical practice during initiation and follow up of patients on HMV. This survey reports clinicians’ practices, with a specific focus on the clinical approaches employed to assess, monitor and manage HMV patients. Methods: A web-based international survey was open between 1 January and 31 March 2023. Results: In total, 114 clinicians responded; 84% of the clinicians downloaded the internal physiological ventilator data when initiating and maintaining HMV patients, and 99% of the clinicians followed up with patients within 3 months. Adherence, leak and the apnea-hypopnea index were the three highest rated items. Oxygen saturation was used to support a diagnosis of nocturnal hypoventilation and was preferred over measurements of carbon dioxide. Furthermore, 78% of the clinicians reviewed data for the assessment of patient ventilator asynchrony (PVA), although the confidence reported in identifying certain PVAs was reported as unconfident or extremely unconfident. Conclusions: This survey confirmed that clinical practice varies and often does not follow the current guidelines. Despite PVA being of clinical interest, its clinical relevance was not clear, and further research, education and training are required to improve clinical confidence. |
| first_indexed | 2024-03-11T11:27:10Z |
| format | Article |
| id | doaj.art-42726c18c5c04c53bad8a5f5956f4b7d |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T11:27:10Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-42726c18c5c04c53bad8a5f5956f4b7d2023-11-10T15:06:30ZengMDPI AGJournal of Clinical Medicine2077-03832023-10-011221680310.3390/jcm12216803International Survey of the Tools Used for Assessment, Monitoring and Management of Home Mechanical Ventilation PatientsMichelle Chatwin0Nicholas Hart1Royal Brompton Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London SW3 6NP, UKLane Fox Respiratory Service St Thomas’ Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UKBackground: There are limited data reporting diagnostic practices, compared to clinical guidelines, for patients with chronic respiratory failure requiring home mechanical ventilation (HMV). There are no data detailing the current use of downloaded physiological monitoring data in day-to-day clinical practice during initiation and follow up of patients on HMV. This survey reports clinicians’ practices, with a specific focus on the clinical approaches employed to assess, monitor and manage HMV patients. Methods: A web-based international survey was open between 1 January and 31 March 2023. Results: In total, 114 clinicians responded; 84% of the clinicians downloaded the internal physiological ventilator data when initiating and maintaining HMV patients, and 99% of the clinicians followed up with patients within 3 months. Adherence, leak and the apnea-hypopnea index were the three highest rated items. Oxygen saturation was used to support a diagnosis of nocturnal hypoventilation and was preferred over measurements of carbon dioxide. Furthermore, 78% of the clinicians reviewed data for the assessment of patient ventilator asynchrony (PVA), although the confidence reported in identifying certain PVAs was reported as unconfident or extremely unconfident. Conclusions: This survey confirmed that clinical practice varies and often does not follow the current guidelines. Despite PVA being of clinical interest, its clinical relevance was not clear, and further research, education and training are required to improve clinical confidence.https://www.mdpi.com/2077-0383/12/21/6803NIVPVAneuromuscular diseasechronic obstructive pulmonary diseaseCOPDventilatory failure |
| spellingShingle | Michelle Chatwin Nicholas Hart International Survey of the Tools Used for Assessment, Monitoring and Management of Home Mechanical Ventilation Patients Journal of Clinical Medicine NIV PVA neuromuscular disease chronic obstructive pulmonary disease COPD ventilatory failure |
| title | International Survey of the Tools Used for Assessment, Monitoring and Management of Home Mechanical Ventilation Patients |
| title_full | International Survey of the Tools Used for Assessment, Monitoring and Management of Home Mechanical Ventilation Patients |
| title_fullStr | International Survey of the Tools Used for Assessment, Monitoring and Management of Home Mechanical Ventilation Patients |
| title_full_unstemmed | International Survey of the Tools Used for Assessment, Monitoring and Management of Home Mechanical Ventilation Patients |
| title_short | International Survey of the Tools Used for Assessment, Monitoring and Management of Home Mechanical Ventilation Patients |
| title_sort | international survey of the tools used for assessment monitoring and management of home mechanical ventilation patients |
| topic | NIV PVA neuromuscular disease chronic obstructive pulmonary disease COPD ventilatory failure |
| url | https://www.mdpi.com/2077-0383/12/21/6803 |
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