Breas | At the Heart of Breathing.™

Vivo 60 insertsWith ever increasing demands on Health Care budgets worldwide, several trends have emerged in the long term mechanical ventilation area (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.

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 ill 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 2000, 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.

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.

Control Mode – The control mode of ventilation delivers only controlled breaths to the patient. The ventilator is triggered by the pre-set machine rate, and inspiration is ended according to the pre-set cycle variables.

Assist/Control Mode – In this mode, the patient is able to initiate a machine assisted breath. The respiratory rate is established by the set machine rate plus any spontaneous breathing from the patient.

Pressure Support – This mode augments a patient’s spontaneous effort with a pre-set amount of positive pressure. Once the sensitivity setting has been triggered, the ventilator increases the flow to reach the pre-set pressure. The expiratory phase begins when the flow rate drops to a pre-set value.

CPAP (Continuous Positive Airway Pressure) – Provides no breathing support but simply elevates airway pressure and maintains this level. In the home environment, this is used primarily in the treatment of obstructive sleep apnea (see the iSleep range of products).

PEEP (Positive End Expiratory Pressure) – This parameter is similar to CPAP, but elevates airway pressure at the end of mechanical ventilator breaths. Primarily used to increase the volume of air remaining in the lungs at the end of expiration (the functional residual capacity).