DOMICILIARY VENTILATION BY TRACHEOTOMY FOR CHRONIC RESPIRATORY-FAILURE

  • 1 January 1983
    • journal article
    • research article
    • Vol. 11  (6) , 923-936
Abstract
Experience, from 1960 onward with 222 patients suffering from terminal chronic respiratory failure is described. Results are reported of domiciliary mechanical ventilation for 11-17 h/day using tacheotomy. The method was easy to use at home at a reasonable cost and was far less than in a medical environment. The results were excellent both for length of survival and quality of life for all cases where respiratory failure was due to chest wall problems (neurological, muscular or restrictive syndromes due to chest deformity). The majority of cases were sequelae of polio, myopathies, kyphoscoliosis or tuberculosis. Results were less good for patients with intrinsic pulmonary disease such as chronic airflow obstruction; for this, the superiority of mechanical ventilation compared to long term O2 therapy is not proven. Resultswere very poor for patients suffering from bronchial dilatation. A positive correlation between the efficacy of the method and the duration of a normal PaO2 [arterial partial pressure] during a 24-h period seemed to exist, both during periods of mechanical ventilation and weaning from the machine.

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