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Evde Mekanik Ventilasyon Uygulaması

Mechanical Ventilation Management at Home

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Abstract (2. Language): 
Home mechanical ventilation is used to treat chronic respiratory insufficiency in patients who are clinically stable and require partial or total ventilation support. We present a patient who provided long-term mechanical ventilation support at home. A-86-year-old man who had received cardiopulmonary resuscitation after sudden cardiac arrest at the second day of TUR-P operation in the ward was admitted to the intensive care unit (ICU)(APACHE II Score:3, GKS:3). He had a history of congestive heart failure and chronic obstructive pulmonary disease. He could not completely wean from ventilatory support. Home mechanical ventilation programme was planned for the ventilatordependent patient after eight months in ICU. The education of the specific features about the patients care had been provided to the persons who would be in charge of his care before he was discharged to home. An intensivist visited for acute episode treatment of chronic obstructive pulmonary disease and physical examination regularly. He died after twenty-two months. He required the ICU support twice during this period.
Abstract (Original Language): 
Evde mekanik ventilasyon uygulaması, tam veya kısmi ventilasyon desteği gereken, kliniği stabil, kronik solunum yetmezliği olan olguların tedavisinde kullanılmaktadır. Evde uzun süreli mekanik ventilasyon uygulanan olguyu sunduk. 86 yaşında erkek olgu, TUR-P operasyonunun ikinci gününde klinikte ani kardiyak arrest gelişmesi üzerine, kardiyopulmoner resüsitasyonu takiben yoğun bakım ünitesine (YBÜ) alındı (APACHE II Skoru:30, GKS:3). Olgu konjestif kalp yetmezliği ve kronik obstrüktif akciğer hastalığı hikayesine sahipti. Ventilatör desteğinden tamamen ayrılamadı. Ventilatöre bağımlı olgu için YBÜ’de sekizinci ayından sonra evde mekanik ventilasyon programı planlandı. Olgu eve gönderilmeden önce, tedavisinde gerekli spesifik ihtiyaçları ve olgunun bakımından sorumlu kişinin eğitimi sağlandı. Kronik obstrüktif akciğer hastalığı akut atağının tedavisi ve fizik muayene için YBÜ uzmanı tarafından düzenli ziyaretleri yapıldı. Olgu yirmi iki ay sonra öldü. Bu dönemde iki kez YBÜ desteği gerekli oldu.

REFERENCES

References: 

1. Douglas SL, Daly BJ. Caregivers of long-term ventilator
patients: physical and psychological outcomes. Chest
2003;123:1073-81.
2. Carson SS, Bach PB, Brzozowski L, Leff A. Outcomes after
long-term acute care: an analysis of 133 mechanically ventilated patients. Am J Respir Crit Care Med 1999;159:1568-73.
3. Douglas SL, Daly BJ, Brennan PF, Gordon NH, Uthis P.
Hospital readmission among long-term ventilator patients.
Chest 2001;120:1278-86.
4. de Lucas Ramos P, Rodriguez Gonzalez-Moro JM, Paz Gonzalez L, Santa-Cruz Siminiani A, Cubillo Marcos JM. Current
status of home mechanical ventilation in Spain: results of a
national survey. Arch Bronconeumol 2000;36:545-50.
5. Farre R, Giro E, Casolive V, Navajas D, Escarrabill J. Quality
control of mechanical ventilation at the patient’s home. Intensive Care Med 2003;29:484-6.
6. Hein H, Schucher B, Magnussen H. Quality of life of various
patient groups during home mechanical ventilation. Med Klin
1999;94:99-101.
7. Markstrom A, Sundell K, Lysdahl M, et al. Quality-of-life
evaluation of patients with neuromuscular and skeletal diseases treated with noninvasive and invasive home mechanical
ventilation. Chest 2002;122:1695-700.
8. Chatila W, Kreimer DT, Criner GJ. Quality of life in survivors
of prolonged mechanical ventilatory support. Crit Care Med
2001;29:737-42. F. N. Kaya, ark.
78
9. Chabot F, Cornette A, Robert V, Vial B, Polu JM. Home
ventilation after intensive care. Rev Mal Respir 2001;18:267-
82.
10. Sivak ED, Cordasco EM, Gipson WT. Pulmonary mechanical
ventilation at home: a reasonable and less expensive alternative. Respir Care 1983;28.42-9.
11. Kawashima N, Matsumoto A, Narita N. Clinical problems of
home mechanical ventilation management for neuromuscular
disorders. Gan To Kagaku Ryoho 1999;2:203-6.
12. Wijkstra PJ, Avendano MA, Goldstein RS. Inpatient chronic
assisted ventilatory care: a 15-year experience. Chest
2003;124:850-6.
13. Covinsky KE, Goldman L, Cook EF, et al. The impact of
serious illness on patients’ families. SUPPORT Investigators.
Study to understand prognoses and preferences for outcomes
and risks of treatment. JAMA 1994;272:1839-44.
14. Stone R, Cafferata GL, Sangl J. Caregivers of the frail elderly:
a national profile. Gerontologist 1987;27:616-26.
15. Miller B, Townsend A, Carpenter E, et al. Social support and
caregiver distress: a replication analysis. J Gerontol B Psychol
Sci Soc Sci 2001;56:249-56.
16. Combes A, Costa MA, Trouillet JL, et al. Morbidity, mortality,
and quality-of-life outcomes of patients requiring >or=14 days
of mechanical ventilation. Crit Care Med 2003;31:1373-81.

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