Document Detail

Home mechanical ventilation through mask: monitoring leakage and nocturnal oxygenation at home.
MedLine Citation:
PMID:  23018542     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Leakage is common in patients receiving home mechanical ventilation (HMV) via a face mask. Although pressure ventilators have partial compensatory capacity, excessive leakage can compromise the effectiveness of treatment. Home ventilators are equipped with built-in software which provides information on leakage. However, the values of leakage and their effects in routine clinical practice are currently little known.
OBJECTIVE: To measure leakage in stable patients on nocturnal HMV and its impact on treatment effectiveness.
METHODS: Consecutive outpatients on HMV were recruited. Nocturnal pulse oximetry was performed at home and leakage was measured using the ventilator's built-in software. We measured: mean SpO(2), percentage of time with SpO(2) <90% (T90), mean leakage (meanL), maximum leakage (maxL), and minimum leakage (minL) during the ventilation session. We estimated ventilator capacity to compensate for leakage according to inspiratory positive airway pressure and divided the patients into two groups: those with leak compensation and those without.
RESULTS: The study included 41 patients [mean age, 64 years (SD 11.9); 23 (56%) women]. Nocturnal pulse oximetry showed an SpO(2) of 94% (±2.9) and a T90 of 10% (±21.7). Leakage (in l/min) was: meanL, 32.2 (±15.3); maxL, 64.8 (±28.5), and minL, 18.8 (±10.6). Seven cases (17%) had leakage greater than the ventilator compensatory capacity, but no significant difference in SpO(2) or T90 was observed between patients with or without leak compensation.
CONCLUSIONS: A wide variation between maxL and minL was observed in our series; 17% of cases had higher leakage values than the compensatory capacity of the ventilator, but this did not affect nocturnal oxygenation.
Ramon Fernandez Alvarez; Gemma Rubinos Cuadrado; Francisco Rodriguez Jerez; Almudena Garcia Garcia; Patricia Rodriguez Menendez; Pere Casan Clara
Publication Detail:
Type:  Journal Article     Date:  2012-09-27
Journal Detail:
Title:  Respiration; international review of thoracic diseases     Volume:  85     ISSN:  1423-0356     ISO Abbreviation:  Respiration     Publication Date:  2013  
Date Detail:
Created Date:  2013-02-14     Completed Date:  2013-08-23     Revised Date:  2013-11-08    
Medline Journal Info:
Nlm Unique ID:  0137356     Medline TA:  Respiration     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  132-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 S. Karger AG, Basel.
Pneumology, Hospital Central de Asturias, Oviedo, Spain.
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MeSH Terms
Cohort Studies
Cross-Sectional Studies
Masks / adverse effects*
Middle Aged
Neuromuscular Diseases / therapy
Respiration, Artificial / adverse effects*
Respiratory Tract Diseases / therapy
Comment In:
Respiration. 2013;86(3):261   [PMID:  23689472 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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