Technological advances in home non-invasive ventilation monitoring: Reliability of data and effect on patient outcomes.
Jean-Christian BorelAlain PalotMaxime PatoutPublished in: Respirology (Carlton, Vic.) (2019)
Home non-invasive mechanical ventilation (NIV) has become a well-established treatment for patients with chronic hypercapnic respiratory failure. NIV monitoring has been developed to evaluate the effectiveness of mechanical ventilation on patient outcomes, with built-in systems providing data on compliance, leaks and respiratory parameters. Although these data seem intuitively useful, two main concerns have been raised in the literature: (i) are they reliable and (ii) to what extent does their use improve patient outcomes. These two concerns are currently relevant since the very recent development of telemonitoring provides the possibility of adjusting ventilator settings remotely, based on the longitudinal assessment of NIV parameters and respiratory variables provided by the system. This may influence the future management strategies of health organizations for patients under home NIV. This narrative review describes technological advances in patient monitoring using home mechanical ventilation with a main focus on data provided by built-in NIV monitoring systems. The use of these systems is discussed, including their advantages and limitations in different clinical situations, and perspectives for long-term patient monitoring are discussed.
Keyphrases
- risk assessment
- mechanical ventilation
- respiratory failure
- acute respiratory distress syndrome
- intensive care unit
- healthcare
- electronic health record
- extracorporeal membrane oxygenation
- big data
- systematic review
- randomized controlled trial
- public health
- case report
- end stage renal disease
- newly diagnosed
- prognostic factors
- mental health
- cross sectional
- smoking cessation