Cargando…
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...
Autores principales: | , , , |
---|---|
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 |
_version_ | 1782437155847536640 |
---|---|
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. |
format | Online Article Text |
id | pubmed-4904519 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT macintyreerikaj clinicaloutcomesassociatedwithhomemechanicalventilationasystematicreview AT asadileyla clinicaloutcomesassociatedwithhomemechanicalventilationasystematicreview AT mckimdouga clinicaloutcomesassociatedwithhomemechanicalventilationasystematicreview AT bagshawseanm clinicaloutcomesassociatedwithhomemechanicalventilationasystematicreview |