Breas | At the Heart of Breathing.™

With ever increasing demands on Health Care budgets worldwide, several trends have emerged in the care of the long term ventilated (LTMV). Technological advances in mechanical ventilation have enabled medical practitioners to support patients indefinitely who suffer from chronic respiratory disorders. In the last decade more patients are being sent home earlier from hospital. There is an increase in the pro-active application of mechanical ventilation of the COPD and the paediatric patient.

Still in keeping with health care structures and budgets, the effort required to deal effectively with these patients has created a need for a wide range of products, which are flexible enough to care for the patient in hospital before continuing to be cared for at home. Breas continues to offer this flexibility of care through the Vivo range of products.

 

Ventilator Patient Needs

Disease groups, which can be treated by mechanical ventilation, either via tracheotomy or non-invasively, can be divided into:

  • Neuromuscular
  • Anatomical defects
  • Pulmonary disease

Still in keeping with health care structures and budgets, the effort required to deal effectively with these patients has created a need for a wide range of locations, ranging from the hospital to the home. Discharge planning is essential in order to ensure a smooth transition and continued care, including technical support, once the patient is home. Health education should play a key role so that the chronically patient can learn to maximise their potential1 and be aware of their own responsibilities during their treatment.

Trends within Mechanical Ventilation

Depending upon their condition or disease state the patient may have been in the Intensive Care unit (ICU), then moved to the High Dependency Unit (HDU) or Respiratory Care unit for weaning and stabilisation purposes. Patients who are stable but who do not have the option of placement outside the Hospital, or who are terminally ill, often stay in the General med/surgical ward. The trend in mechanical ventilation is towards treating the patient non-invasively and providing mechanical ventilation more pro-actively for the paediatric and chronically obstructed or restricted patient for their future improved outcomes.

The number of patients receiving mechanical ventilation both in the home and at sites outside the acute care hospital is increasing. Long-term care may be provided via skilled nursing facilities and living-in centres/clinics for patients whose disease states are too far advanced or who are suffering weaning difficulties. Patients in all groups have improved survivals and quality of life when ventilator assisted (VAI) or treated with long-term mechanical ventilation (LTMV). Patients with restrictive thoracic disorders consistently have an improvement in symptoms of chronic hypoventilation and better quality of sleep after starting ventilatory assistance. In a survey by A.K. Simonds et al 2, 73% of the patients had less fatigue, 44% less breathlessness and 48% decreased frequency of respiratory infections. The majority of patients were able to return to work at home and some returned to professional work.

1. Brown S, Mann R. Profess Nurse 1990; 3 : 325-8
2.Thorax 1995: 50:604-609

The World Health Organisation, WHO, estimated that in the year 2000, 2.74 million deaths were caused by COPD, chronic obstructive pulmonary disease. In 1990 it was ranked 12th as a burden of disease, by 2020 it is projected to rank 5th. Loosening and removal of secretions in the airways accelerates blood-gas exchange in the oxygen starved COPD patient, helps to prevent pulmonary infections, improves ventilation and decreases the need for invasive mechanical ventilation. (Bach J, CHEST 1998:112 1024-1028 CHEST 1993: 104 : 1553-1562)

For all patient types, whether long-term ventilation, weaning, non-invasive respiratory support or ventilation therapy, safety, comfort, control and ease of use are paramount for the patient. Vivo has the solution to their needs, please view the Vivo Products & Solutions and contact us for more information.

 

Information for Clinicians

With ever increasing demands on healthcare budgets worldwide, several trends have emerged in the care of the long term ventilated (LTMV). Technological advances in mechanical ventilation have enabled medical practitioners to support patients indefinitely who suffer from chronic respiratory disorders. In the last decade more patients are being sent home earlier from hospital. There is an increase in the pro-active application of mechanical ventilation of the COPD and the paediatric patient.

Still in keeping with health care structures and budgets, the effort required to deal effectively with these patients has created a need for a wide range of products, which are flexible enough to care for the patient in hospital before continuing to be cared for at home. Breas continues to offer this flexibility of care through the Vivo range of products.

 

Breas | Beatmungs Modi

Kontrollierter Modus (PCV/VCV) – Der kontrollierte Modus liefert dem Patienten nur kontrollierte Atemzüge. Das Beatmungsgerät löst Atemzüge durch die eingestellte Frequenz aus und die Inspiration endet gemäß den eingestellten Parametern.

Assistierter/Kontrollierter Modus (PCV-A/VCV-A) – In diesem Modus ist es dem Patienten möglich, einen vom Gerät assistierten Atemzug auszulösen. Die gesamte Atemfrequenz besteht aus voreingestellten plus vom Patienten spontan angeforderten Atemzügen.

Druck Unterstützt (PSV-A) – Dieser Modus erleichtert die Spontanatmung eines Patienten, indem er mit einem voreingestellten positiven Druck unterstützt wird. Einmal ausgelöst, erhöht das Beatmungsgerät den Flow um den eingestellten Druck zu erreichen. Die Exspirationsphase beginnt, wenn der Flow auf den entsprechend eingestellten Wert fällt.

CPAP (Continuous Positive Airway Pressure) – Unterstützt nicht die Atmung erhöht jedoch den Atemwegsdruck und hält diesen aufrecht. Diese Funktion wird hauptsächlich im häuslichen Umfeld verwendet um obstruktive Schlaf Apnoe zu behandeln. (Siehe auch iSleep Produkt Familie).

PEEP (Positive End Expiratory Pressure) – Dieser Parameter ist ähnlich zu CPAP, erhält aber den Atemwegsdruck am Ende jedes mechanischen Atemzugs. Der PEEP wird hauptsächlich verwendet um das in den Lungen verbleibende Restvolumen am Ende der Exspiration zu erhöhen. (Funktionelle verbleibende Kapazität)