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Clinical Outcomes Associated with Home Mechanical Ventilation: A Systematic Review

Background. The prevalence of patients supported with home mechanical ventilation (HMV) for chronic respiratory failure has increased. However, the clinical outcomes associated with HMV are largely unknown. Methods. We performed a systematic review of studies evaluating patients receiving HMV for in...

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Autores principales: MacIntyre, Erika J., Asadi, Leyla, Mckim, Doug A., Bagshaw, Sean M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4904519/
https://www.ncbi.nlm.nih.gov/pubmed/27445559
http://dx.doi.org/10.1155/2016/6547180
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author MacIntyre, Erika J.
Asadi, Leyla
Mckim, Doug A.
Bagshaw, Sean M.
author_facet MacIntyre, Erika J.
Asadi, Leyla
Mckim, Doug A.
Bagshaw, Sean M.
author_sort MacIntyre, Erika J.
collection PubMed
description Background. The prevalence of patients supported with home mechanical ventilation (HMV) for chronic respiratory failure has increased. However, the clinical outcomes associated with HMV are largely unknown. Methods. We performed a systematic review of studies evaluating patients receiving HMV for indications other than obstructive lung disease, reporting at least one clinically relevant outcome including health-related quality of life (HRQL) measured by validated tools; hospitalization requirements; caregiver burden; and health service utilization. We searched MEDLINE, EMBASE, CINAHL, the Cochrane library, clinical trial registries, proceedings from selected scientific meetings, and bibliographies of retrieved citations. Results. We included 1 randomized control trial (RCT) and 25 observational studies of mixed methodological quality involving 4425 patients; neuromuscular disorders (NMD) (n = 1687); restrictive thoracic diseases (RTD) (n = 481); obesity hypoventilation syndrome (OHS) (n = 293); and others (n = 748). HRQL was generally described as good for HMV users. Mental rather than physical HRQL domains were rated higher, particularly where physical assessment was limited. Hospitalization rates and days in hospital appear to decrease with implementation of HMV. Caregiver burden associated with HMV was generally high; however, it is poorly described. Conclusion. HRQL and need for hospitalization may improve after establishment of HMV. These inferences are based on relatively few studies of marked heterogeneity and variable quality.
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spelling pubmed-49045192016-06-30 Clinical Outcomes Associated with Home Mechanical Ventilation: A Systematic Review MacIntyre, Erika J. Asadi, Leyla Mckim, Doug A. Bagshaw, Sean M. Can Respir J Review Article Background. The prevalence of patients supported with home mechanical ventilation (HMV) for chronic respiratory failure has increased. However, the clinical outcomes associated with HMV are largely unknown. Methods. We performed a systematic review of studies evaluating patients receiving HMV for indications other than obstructive lung disease, reporting at least one clinically relevant outcome including health-related quality of life (HRQL) measured by validated tools; hospitalization requirements; caregiver burden; and health service utilization. We searched MEDLINE, EMBASE, CINAHL, the Cochrane library, clinical trial registries, proceedings from selected scientific meetings, and bibliographies of retrieved citations. Results. We included 1 randomized control trial (RCT) and 25 observational studies of mixed methodological quality involving 4425 patients; neuromuscular disorders (NMD) (n = 1687); restrictive thoracic diseases (RTD) (n = 481); obesity hypoventilation syndrome (OHS) (n = 293); and others (n = 748). HRQL was generally described as good for HMV users. Mental rather than physical HRQL domains were rated higher, particularly where physical assessment was limited. Hospitalization rates and days in hospital appear to decrease with implementation of HMV. Caregiver burden associated with HMV was generally high; however, it is poorly described. Conclusion. HRQL and need for hospitalization may improve after establishment of HMV. These inferences are based on relatively few studies of marked heterogeneity and variable quality. Hindawi Publishing Corporation 2016 2016-04-28 /pmc/articles/PMC4904519/ /pubmed/27445559 http://dx.doi.org/10.1155/2016/6547180 Text en Copyright © 2016 Erika J. MacIntyre et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
MacIntyre, Erika J.
Asadi, Leyla
Mckim, Doug A.
Bagshaw, Sean M.
Clinical Outcomes Associated with Home Mechanical Ventilation: A Systematic Review
title Clinical Outcomes Associated with Home Mechanical Ventilation: A Systematic Review
title_full Clinical Outcomes Associated with Home Mechanical Ventilation: A Systematic Review
title_fullStr Clinical Outcomes Associated with Home Mechanical Ventilation: A Systematic Review
title_full_unstemmed Clinical Outcomes Associated with Home Mechanical Ventilation: A Systematic Review
title_short Clinical Outcomes Associated with Home Mechanical Ventilation: A Systematic Review
title_sort clinical outcomes associated with home mechanical ventilation: a systematic review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4904519/
https://www.ncbi.nlm.nih.gov/pubmed/27445559
http://dx.doi.org/10.1155/2016/6547180
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