title: The evolution of home mechanical ventilation in poland between 2000 and 2010.
abstract: BACKGROUND
  Home mechanical ventilation (HMV) is a routine method of treatment for patients with chronic ventilatory failure. Over the last 20 y, a marked development in HMV has been noted in terms of its prevalence and the changing proportion of patients with various indications. However, data on HMV come exclusively from the developed countries of Europe and North America. Nowadays, we can see the emergence of HMV in less developed countries. This study aimed to describe the development of HMV in Poland.
  
  
  METHODS
  Data from the largest HMV centers were retrospectively evaluated with regard to cause of respiratory failure, ventilation technique, and characteristics of the HMV-implementing institution.
  
  
  RESULTS
  The number of subjects treated with HMV increased from 8 in 2000 to 928 in 2010. Neuromuscular diseases remained the main indication. However, their relative contribution decreased from 100 to 51% in favor of pulmonary diseases (an increase from 0 to 21%) and hypoventilation syndromes (0% in 2000 and 11% in 2010). The majority of the HMV population treated between 2000 between 2008 was ventilated by tracheostomy; however, since 2007, the percentage of subjects on noninvasive ventilation significantly increased and was equal to the number of tracheostomized subjects. HMV was initiated mainly in ICUs. However, their role systematically diminished, and an increasing number of subjects were recruited in respiratory departments.
  
  
  CONCLUSIONS
  The prescription pattern of HMV in Poland has evolved, and there is a clear shift from neuromuscular to respiratory diseases. The prevalence of ventilation via tracheostomy still remains very high in comparison with other European countries. The Polish experience could be useful for countries with emerging HMV care systems.
authors.affiliation: Department of Internal Medicine, Pneumology and Allergology, Medical University of Warsaw, Warsaw, Poland. jnasilowski@wum.edu.pl.
authors.forename: Jacek
authors.initials: J
authors.lastname: Nasiłowski
authors.affiliation: Home Mechanical Ventilation Center, Dom Sue Ryder, Bydgoszcz, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Wachulski
authors.affiliation: Home Mechanical Ventilation Center, VentaMed, Zielona Góra, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Trznadel
authors.affiliation: Lodz Hospice for Children, Łódź, Poland.
authors.forename: Witalij
authors.initials: W
authors.lastname: Andrzejewski
authors.affiliation: Pediatric Intensive Care Unit, Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Migdał
authors.affiliation: Home Mechanical Ventilation Center, BetaMed, Katowice, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Drozd
authors.affiliation: Home Mechanical Ventilation Center, HELP, Poznań, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Pytel
authors.affiliation: Home Mechanical Ventilation Center, HELP, Poznań, Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Suchanke
authors.affiliation: Department of Pulmonary Diseases and Respiratory Failure, Kuyavian-Pomeranian Regional Pulmonology Centre, Bydgoszcz, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Czajkowska-Malinowska
authors.affiliation: Home Mechanical Ventilation Center, St Vincent Medical Center, Warsaw, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Majszyk
authors.affiliation: Home Ventilation Center, Medycyna Specjalistyczna, Bydgoszcz, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Szkulmowski
authors.affiliation: Department of Internal Medicine, Pneumology and Allergology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Ryszarda
authors.initials: R
authors.lastname: Chazan
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D008171:Lung Diseases / Q000150:complications / Q000453:epidemiology*; D009468:Neuromuscular Diseases / Q000150:complications / Q000453:epidemiology*; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D012121:Respiration, Artificial / Q000379:methods / Q000706:statistics & numerical data*; D012131:Respiratory Insufficiency / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D014139:Tracheostomy / Q000706:statistics & numerical data
keywords: chronic respiratory failure; epidemiology; home mechanical ventilation; invasive ventilation; noninvasive ventilation