Title of article :
Clinical Outcomes Associated with Home Mechanical Ventilation: A Systematic Review
Author/Authors :
MacIntyre, Erika J. Division of Critical Care Medicine - Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada , Asadi, Leyla Department of Medicine - Faculty of Medicine and Dentistry - University of Alberta, Edmonton, Canada , Mckim, Doug A. Division of Respirology and Respiratory Rehabilitation Services - Faculty of Medicine and Dentistry - University of Ottawa, Ottawa, Canada , Bagshaw, Sean M. Division of Critical Care Medicine - Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
Abstract :
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.
Keywords :
Clinical Outcomes , Ventilation , with Home Mechanical
Journal title :
Canadian Respiratory Journal