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Clinical Indications of home ventilation

Clinical Indications of home ventilation

Clinical Indications

  • Restrictive or mixed syndrome with alveolar hypoventilation.
  • Palliative cases after a decompensation or patient who can not weaned from ventilator.

Patients attained by chronic respiratory insufficiency with alveolar hypoventilation  and hypercapnia:

  • nocturnal PtcCO2 (transcutaneous pressure ofthe carbon dioxide) > 50 mmHg; and/or fordiurnal  PACO2 (arterialpartial pressure of the carbon dioxide) >45 mmHg.
  • In case of failure of the long-term oxygénothérapy in COPD patients with clinical signs of hypoventilation, PACO2> 55 mmHg and frequent hospitalisations for exacerbations.

The prescription informations

  • The type of prescript: initiation, renewal, changing parameters
  • type of ventilation: invasive or not;
  • The type of ventilator: without battery, with internal battery, or life support;
  • brand and model of the ventilator (compulsory in paediatrics patients) with the parameters;
  • The length of daily ventilation (nocturne± diurnal);
  • The parameters of ventilation (Inspiratory Pressure, expiratory pressure, frequency …)
  • The type of interface (mark and model are compulsory  in pediatrics);
  • The type of circuit;
  • accessories (humidification, oximeter, alarms…..).
  • The monitoring of the ventilation SPO2;Ptc CO2;polygraphy…

The 4 objectives of the ventilation

Reduce the work of breathing Increase alveolar ventilation Improve gas exchanges Normalise  blood gases

 

Non invasive ventilation contraindication

  • Absence of motivation and the collaboration of the patient
  • strict Disturbances of swallowing
  • bronchial Blockage resistant to assisted cough