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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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Detalles Bibliográficos
Autores principales: Chatwin, Michelle, Hart, Nicholas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10649660/
https://www.ncbi.nlm.nih.gov/pubmed/37959266
http://dx.doi.org/10.3390/jcm12216803
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author Chatwin, Michelle
Hart, Nicholas
author_facet Chatwin, Michelle
Hart, Nicholas
author_sort Chatwin, Michelle
collection PubMed
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.
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spelling pubmed-106496602023-10-27 International Survey of the Tools Used for Assessment, Monitoring and Management of Home Mechanical Ventilation Patients Chatwin, Michelle Hart, Nicholas J Clin Med Communication 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. MDPI 2023-10-27 /pmc/articles/PMC10649660/ /pubmed/37959266 http://dx.doi.org/10.3390/jcm12216803 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Communication
Chatwin, Michelle
Hart, Nicholas
International Survey of the Tools Used for Assessment, Monitoring and Management of Home Mechanical Ventilation Patients
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 Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10649660/
https://www.ncbi.nlm.nih.gov/pubmed/37959266
http://dx.doi.org/10.3390/jcm12216803
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