Clinical considerations in the implementation of home care ventilation: observations in 24 patients1
Edward D. Sivak, M.D.
Edward M. Cordasco, M.D.
W. Terry Gipson, M.D.
Kay Stelmak, R.N., A.R.R.T.
The assessment and management of 24 patients with compromized respiratory systems, in our experience, suggest that the physiological support delivered by mechanical ventilation can improve the clinical status of such patients. Clinical observations of recurrent respiratory failure, progressive deterioration in exercise tolerance, and/or symptoms of alveolar hypoventilation due to hypercarbia and hypoxemia were sufficient to warrant clinical trials of assisted mechanical ventilation. Long-term management goals included supportive care for patients with progressive neuromuscular diseases and rehabilitation in patients with restrictive chest wall disease or diaphragmatic paralysis.