Luca Valkó, Szabolcs Baglyas, András Lorx, János Gál
Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest
Chronic respiratory failure requires long term mechanical ventilation which can be provided through noninvasive interfaces or a tracheostomy. Home mechanical ventilation has been increasingly used to lessen financial burden of health care and improve quality of life for these patients. While ventilation through a tracheostomy is technically more feasible, complication rates can be higher and quality of life can be affected.
To identify factors influencing quality of life for patients receiving home mechanical ventilation.
We evaluated 36 patients receiving home mechanical ventilation. We recorded demographic data, lung function tests, arterial oxygen pressure and quality of life percentage verified by the Severe Respiratory Insufficiency Questionnaire (SRI). Results are expressed as mean±standard deviation. Data was analyzed by Mann-Whitney, one-way ANOVA and Pearson correlation tests, p<0,05 was deemed significant.
The causes of chronic respiratory failure were neuromuscular disease (47,2%), obesity-hypoventilation syndrome (22,2%), chronic obstructive pulmonary disease (19,4%) and restrictive chest wall disease (11,1%). Mode of ventilation was invasive in 19,4%, noninvasive in 80,6% of patients. Daily ventilation need was 10,6+4,8 hours. SRI showed an overall 65,2±14,3% quality of life. While O2 supplementation need (p=0,002), arterial oxygen pressure (p=0,039), forced vital capacity (p<0,001), peak expiratory flow (p=0,002) and peak inspiratory flow (p=0,017) of lung function tests differed significantly in different disease groups, quality of life did not (p=0,23). Quality of life correlated with peak expiratory flow (PEF) (correlation factor: 0,377; p=0,025) but was not different in patients ventilated invasively or noninvasively (58,9±11,5 vs 66,7±11,5%; p=0,196).
Our results reflect that home mechanical ventilation can provide good quality of life independent of disease type. The most reliant variable correlating with quality of life was PEF, underlining the importance of physical therapy and adequate secretion management. Invasive ventilation was not associated with a worsened quality of life compared to noninvasive ventilation.
Doctoral School: Clinical Medicine
Program: Pulmonology, Physiology of ventilation, respiratory mechanics
Supervisor: András Lorx
E-mail address: email@example.com