Home mechanical ventilation: quality of life patterns after six months of treatment

• Published in: BMC pulmonary medicine Vol. 20; no. 1; pp. 1 - 221
• Main Authors: Valko, Luca, Baglyas, Szabolcs, Gyarmathy, V. Anna, Gal, Janos, Lorx, Andras
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 17.08.2020; BioMed Central; BMC
• Subjects: Amyotrophic lateral sclerosis; Bubbles; Care and treatment; Chronic illnesses; Chronic obstructive pulmonary disease; Chronic respiratory failure; Contraindications; Diagnosis; Disease; Domiciliary ventilation; Health aspects; Home care; Home mechanical ventilation; Hypoventilation; Long term ventilation; Lung diseases; Mechanical ventilation; Methods; Neuromuscular diseases; Obstructive lung disease; Ostomy; Oxygen; Patients; Pulmonology; Quality of life; Quality of life change; Questionnaires; Respiratory failure; Respiratory insufficiency; Sleep; Studies; Supplements; Surveys; Tracheotomy; Ventilators; Hungary
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-020-01262-z

Abstract Background It has been shown that home mechanical ventilation improves quality of life, but it has not been widely studied which particular patient groups benefit the most from starting this type of therapy. The purpose of this prospective observational study was to evaluate quality of life change patterns 6 months after initiation of home mechanical ventilation in patients suffering from chronic respiratory failure using patient reported outcomes. Methods We enrolled 74 chronic respiratory failure patients starting invasive or noninvasive home mechanical ventilation through the Semmelweis University Home Mechanical Ventilation Program. Quality of life was evaluated at baseline and at 6 months after initiation of home mechanical ventilation using the Severe Respiratory Insufficiency Questionnaire. Results Overall quality of life showed 10.5% improvement 6 months after initiation of home mechanical ventilation ( p  < 0.001). The greatest improvement was observed in Respiratory complaint (20.4%, p  = 0.015), Sleep and attendant symptoms (19.3%, p  < 0.001), and Anxiety related subscales (14.4%, p  < 0.001). Interface (invasive versus noninvasive ventilation) was not associated with improvement in quality of life ( p  = 0.660). Severely impaired patients showed the greatest improvement (CC = -0.328, p  < 0.001). Initial diagnosis contributed to the observed change ( p  = 0.025), with chronic obstructive pulmonary disease and obesity hypoventilation syndrome patients showing the greatest improvement, while amyotrophic lateral sclerosis patients showed no improvement in quality of life. We found that patients who were started on long term ventilation in an acute setting, required oxygen supplementation and had low baseline quality of life, showed the most improvement during the six-month study period. Conclusions Our study highlights the profound effect of home mechanical ventilation on quality of life in chronic respiratory failure patients that is indifferent of ventilation interface but is dependent on initial diagnosis and some baseline characteristics, like acute initiation, oxygen supplementation need and baseline quality of life. Trial registration This study was approved by and registered at the ethics committee of Semmelweis University (SE TUKEB 251/2017; 20th of December, 2017).