Résumé :
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The Lane-Fox Respiratory Unit (LFRU) is a 14-bed unit with a specialist multidisciplinary team of physicians, nurses and therapists and an 'in-house' technical department. We currently manage 792 patients on HMV in the community. These include patients with chronic respiratory failure as a consequence of neuromuscular disease (NMD), chest wall disease (CWD), chronic obstructive pulmonary disease (COPD) and obesity-related respiratory failure (ORRF). The patients range from those who are tracheostomy ventilator dependent to those requiring only nocturnal ventilatory support. The aim of this study was to ascertain whether the recent change in HMV user demographics (increasing proportion of ORRF with and relative reduction in NMD, CWD and COPD) had influenced ventilator use and mortality. The data was collected prospectively and cross-referenced with the electronic discharge summary database. The results are shown below. Other = post surgical, Prader-Willi syndrome, acute lung injury, cystic fibrosis. Within the NMD and CWD group, 4 deaths (15%) related to Duchene Muscular dystrophy with an average age of 20.5 (1.2) years. There were 5 deaths (19%) in the post poliomyelitis group, 5 (19%) in the motor neurone disease group and 2 in the Guillain Barré group. In the group as a whole, 36% died at home and 64% died in hospital. We observed the highest mortality in the NMD and CWD group, which was the group with the longest use of ventilatory support and the greatest adherence to ventilation reflecting increasing ventilator dependency with disease progression. Ventilator adherence at almost 10 hours per day was unusually high, compared with our previous data, in the COPD group. In OHS ventilator use was the lowest whilst gas exchange was relatively well preserved. These findings are similar to previous review in our unit with mortality being closely related to underlying cause of respiratory failure. brochure_80p_xp :Mise en page 1 12/03/09 20 :16 Page 65
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