8(th) International conference on management and rehabilitation of chronic respiratory failure: the long summaries – Part 3

Ambrosino, Nicolino; Casaburi, Richard; Chetta, Alfredo; Clini, Enrico; Donner, Claudio F.; Dreher, Michael; Goldstein, Roger; Jubran, Amal; Nici, Linda; Owen, Caroline A.; Rochester, Carolyn; Tobin, Martin J.; Vagheggini, Guido; Vitacca, Michele; ZuWallack, Richard

The prevalence of home ventilation is influenced by the increasing incidence of the underlying disorders, the increased knowledge of the healthcare providers (HCP) regarding the option of being safely ventilated outside of the ICU and the guidelines and recommendations of professional societies regarding LTMV [3] . It is also influenced by the attitudes and preferences of the patient and family as well as the availability of formal and informal (caregiver) support services. In Europe (Fig. 3) [4] the prevalence of HMV varies widely (France 17/100,000 to Poland 0.1 per 100,000), as does the distribution of diseases requiring ventilatory support (thoracic cage disorders, neuromuscular disorders and airway disorders). If the patient is unable to return home immediately, a chronic assisted ventilatory care (CAVC) unit will provide a safe, non-acute care environment with a rehabilitative focus, to optimize health related quality of life and promote autonomy. The CAVC unit requires a multidimensional continuum of services, by an interdisciplinary team trained both in ventilator management and rehabilitation. The preferred patient is medically stable, mentally alert, understands that ventilatory assistance is long term, is prepared to participate in comprehensive training and will relocate with appropriate supports. In order for a patient to return home, it must be safe and have the required utilities as well as trained care givers. The availability of home health care, technical support and organized followup is critical.