Long-term management of the ventilator-dependent patient
Edward D. Sivak, M.D.
Department of Pulmonary Disease, The Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44106
The care of the ventilator-dependent patient should be classified as custodial or rehabilitative. The goals of custodial care range from patient comfort to emotional stabilization of patient and family domestic situations. The goals of rehabilitative care range from patient self-sufficiency to complete weaning from mechanical ventilation. Patient evaluation for home care should be done by a home care team consisting of the patients’ physicians, intensive care unit nurses, home respiratory therapists, social workers, physical and occupational therapists, and dietitians. Essential factors required for successful home care ventilation include motivated patients and families, suitable home facilities, and the absence of other medical conditions which will preclude long-term survival.