title: Complementary home mechanical ventilation techniques. SEPAR Year 2014.
abstract: This is a review of the different complementary techniques that are useful for optimizing home mechanical ventilation (HMV). Airway clearance is very important in patients with HMV and many patients, particularly those with reduced peak cough flow, require airway clearance (manual or assisted) or assisted cough techniques (manual or mechanical) and suctioning procedures, in addition to ventilation. In the case of invasive HMV, good tracheostomy cannula management is essential for success. HMV patients may have sleep disturbances that must be taken into account. Sleep studies including complete polysomnography or respiratory polygraphy are helpful for identifying patient-ventilator asynchrony. Other techniques, such as bronchoscopy or nutritional support, may be required in patients on HMV, particularly if percutaneous gastrostomy is required. Information on treatment efficacy can be obtained from HMV monitoring, using methods such as pulse oximetry, capnography or the internal programs of the ventilators themselves. Finally, the importance of the patient's subjective perception is reviewed, as this may potentially affect the success of the HMV.
authors.affiliation: Servicio de Neumología, Hospital Universitari Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, España. Electronic address: echinervives@gmail.com.
authors.forename: Eusebi
authors.initials: E
authors.lastname: Chiner
authors.affiliation: Servicio de Neumología, Hospital Universitari Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, España.
authors.forename: José N
authors.initials: JN
authors.lastname: Sancho-Chust
authors.affiliation: Servicio de Neumología, Hospital Universitari Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, España.
authors.forename: Pedro
authors.initials: P
authors.lastname: Landete
authors.affiliation: Servicio de Neumología, Hospital Universitari Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, España.
authors.forename: Cristina
authors.initials: C
authors.lastname: Senent
authors.affiliation: Servicio de Neumología, Hospital Universitari Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, España.
authors.forename: Elia
authors.initials: E
authors.lastname: Gómez-Merino
mesh_terms: D000402:Airway Obstruction / Q000517:prevention & control; D000529:Complementary Therapies / Q000379:methods* / Q000523:psychology; D003371:Cough; D003948:Diagnostic Techniques, Respiratory System / Q000295:instrumentation; D005544:Forecasting; D006699:Home Care Services; D006801:Humans; D007738:Kyphosis / Q000150:complications; D018529:Nutritional Support; D010845:Obesity Hypoventilation Syndrome / Q000628:therapy; D010361:Patients / Q000523:psychology; D011175:Positive-Pressure Respiration; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000628:therapy; D011788:Quality of Life; D012121:Respiration, Artificial / Q000379:methods* / Q000523:psychology; D012600:Scoliosis / Q000150:complications; D020919:Sleep Disorders, Intrinsic / Q000209:etiology / Q000628:therapy; D013396:Suction; D014139:Tracheostomy / Q000295:instrumentation / Q000379:methods; D012122:Ventilators, Mechanical
keywords: Airway clearance; Estudios de sueño; Home mechanical ventilation; Manejo de secreciones respiratorias; Monitorización respiratoria; Respiratory monitoring; Sleep studies; Tracheostomy; Traqueostomía; Ventilación mecánica domiciliaria