Long-term mechanical ventilation survey

Although home mechanical ventilation is common in western countries, it is still extremely rare in Taiwan. The objectives of this study are (1) to review retrospectively the types of disorders and outcomes of these patients requiring prolonged mechanical ventilation (MV), and (2) to survey the home status of twelve patients on home mechanical ventilation. From January 1990 to April 1992, one hundred fifteen patients receiving prolonged MV ( > or = 30 days & > or = 8-10 hrs/day) were studied in the medical intensive care unit at Chang Gung Memorial Hospital. Eighty-two patients (71.3%) for whom long-term MV were thought to be beneficial were divided into three groups by disorder: (1)primary pulmonary disorder (N = 55, 67.07%) (2) neuromuscular disorder (N = 18, 21.95%), (3) brain stem disorder (N = 9, 10.98%). The outcomes of these eighty-two patients were as follows: expired, 37 (45.12%), completely weaned, 21 (25.61%), unweanable 24, including 12 (14.63%) hospitalized and 12 (14.63%) discharged home. The three outcomes of prolonged MV were significantly associated with the three types of disorder (P = 0.0035). Among these three disorders, duration of MV were longest in the neuromuscular group, whatever the outcome. There was significant difference in the duration of MV for the different outcomes of group I & group III. The mean duration at home for the twelve home MV patients (5 male and 7 female, mean age +/- SD = 46.08 +/- 20.83 years old) was 9.93 +/- 8.11 month, with the longest being 21.5 months. Four expired within two months of discharge to home, two patients had to be readmitted once (one C2-C5 spinal cord injury patient for pneumonia, and the other for brain stem deterioration). When comparing hospital stay, four patients improved in the maximal free time (the mean improvement, 5.75 +/- 3.11 hours/day), seven remained unchanged, while one regressed.(ABSTRACT TRUNCATED AT 250 WORDS)