Yonsei Med J.  2014 Nov;55(6):1729-1735. 10.3349/ymj.2014.55.6.1729.

Home Mechanical Ventilation in South Korea

• Kim DH
• Kang SW
• Choi WA

• KMID: 2070224
• DOI: http://doi.org/10.3349/ymj.2014.55.6.1729

Abstract

PURPOSE
To survey the use of invasive and noninvasive home mechanical ventilation (HMV) methods in South Korea from the perspective of physical medicine and rehabilitation (PM&R).
MATERIALS AND METHODS
For 413 users of HMV, retrospective reviews of PM&R interventions and survey of HMV methods employed from Mar 2000 to Dec 2009.
RESULTS
Of the 413 users, the majority of whom with progressive neuromuscular disorders (NMDs) (n=358), 284 patients initially used noninvasive mechanical ventilation (NIV), while 63 others who were using tracheostomy mechanical ventilation switched to NIV as part of their rehabilitation. The NMD patients began HMV at an earlier age (34.9+/-20.3 yrs), and used for longer (14.7+/-7.5) hours than patients with non-neuromuscular causes of respiratory impairment.
CONCLUSION
Noninvasive management was preferred over invasive ones, and transition to the former was a result of PM&R interventions.

Keyword

Home mechanical ventilation; noninvasive mechanical ventilation; neuromuscular disease

MeSH Terms

Adult
Female
Health Care Surveys
Home Care Services/*statistics & numerical data
Humans
Male
Middle Aged
Muscular Dystrophies/*therapy
Neuromuscular Diseases/therapy
Republic of Korea
Respiration, Artificial/*statistics & numerical data
Retrospective Studies
Ventilators, Mechanical/*statistics & numerical data

Figure

• 

  Fig. 1 Flow diagram of HMV application. HMV, home mechanical ventilation; TMV, tracheostomy mechanical ventilation; NIV, noninvasive mechanical ventilation.

Reference

1. Racca F, Berta G, Sequi M, Bignamini E, Capello E, Cutrera R, et al. Long-term home ventilation of children in Italy: a national survey. Pediatr Pulmonol. 2011; 46:566–572.

2. Spruit MA, Clini EM. Towards health benefits in chronic respiratory diseases: pulmonary rehabilitation. Eur Respir Rev. 2013; 22:202–204.

3. Hill NS. Pulmonary rehabilitation. Proc Am Thorac Soc. 2006; 3:66–74.

4. Bach JR, Gonçalves MR, Hon A, Ishikawa Y, De Vito EL, Prado F, et al. Changing trends in the management of end-stage neuromuscular respiratory muscle failure: recommendations of an international consensus. Am J Phys Med Rehabil. 2013; 92:267–277.

5. Lloyd-Owen SJ, Donaldson GC, Ambrosino N, Escarabill J, Farre R, Fauroux B, et al. Patterns of home mechanical ventilation use in Europe: results from the Eurovent survey. Eur Respir J. 2005; 25:1025–1031.

6. Morris JF, Koski A, Johnson LC. Spirometric standards for healthy nonsmoking adults. Am Rev Respir Dis. 1971; 103:57–67.

7. Kang SW, Bach JR. Maximum insufflation capacity. Chest. 2000; 118:61–65.

8. Lee SC, Park JH, Kang SW, Kim DH, Song SH. External control of exhalation for cough assistance: a method for patients with glottis dysfunction and/or tracheostomy. Arch Phys Med Rehabil. 2009; 90:1402–1407.

9. Bach JR, Saporito LR. Criteria for extubation and tracheostomy tube removal for patients with ventilatory failure. A different approach to weaning. Chest. 1996; 110:1566–1571.

10. Kim DH, Kang SW, Choi W, Moon JH, Baek JH, Choi SH, et al. A research on the management of ventilatory insufficiency in patients with neuromuscular diseases. J Korean Acad Rehabil Med. 2010; 34:347–354.

11. Kang SW, Park JH, Ryu HH, Kang YS, Moon JH. Non-invasive mechanical ventilator care for the patients with advanced neuromuscular disease. J Korean Acad Rehabil Med. 2004; 28:71–77.

12. Dybwik K, Tollåli T, Nielsen EW, Brinchmann BS. Why does the provision of home mechanical ventilation vary so widely? Chron Respir Dis. 2010; 7:67–73.

13. Louwerse ES, Visser CE, Bossuyt PM, Weverling GJ. Amyotrophic lateral sclerosis: mortality risk during the course of the disease and prognostic factors. The Netherlands ALS Consortium. J Neurol Sci. 1997; 152:Suppl 1. S10–S17.

14. Bach JR, Martinez D. Duchenne muscular dystrophy: continuous noninvasive ventilatory support prolongs survival. Respir Care. 2011; 56:744–750.

15. Ishikawa Y, Miura T, Ishikawa Y, Aoyagi T, Ogata H, Hamada S, et al. Duchenne muscular dystrophy: survival by cardio-respiratory interventions. Neuromuscul Disord. 2011; 21:47–51.