title: Management of Ventilatory Insufficiency in Neuromuscular Patients Using Mechanical Ventilator Supported by the Korean Government.
abstract: Since 2001, financial support has been provided for all patients with neuromuscular disease (NMD) who require ventilatory support due to the paralysis of respiratory muscles in Korea. The purpose of this study was to identify ventilator usage status and appropriateness in these patients. We included 992 subjects with rare and incurable NMD registered for ventilator rental fee support. From 21 February 2011 to 17 January 2013, ventilator usage information, regular follow-up observation, and symptoms of chronic hypoventilation were surveyed by phone. Home visits were conducted for patients judged by an expert medical team to require medical examination. Abnormal ventilatory status was assessed by respiratory evaluation. Chronic respiratory insufficiency symptoms were reported by 169 of 992 subjects (17%), while 565 subjects (57%) did not receive regular respiratory evaluation. Ventilatory status was abnormal in 102 of 343 home-visit subjects (29.7%). Although 556 subjects (56%) reported 24-hour ventilator use, only 458 (46%) had an oxygen saturation monitoring device, and 305 (31%) performed an airstacking exercise. A management system that integrates ventilator usage monitoring, counselling and advice, and home visits for patients who receive ventilator support could improve the efficiency of the ventilator support project.
authors.affiliation: Department of Rehabilitation Medicine, Pulmonary Rehabilitation Center, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Korea .
authors.forename: Seong-Woong
authors.identifier: 0000-0002-7279-3893
authors.initials: SW
authors.lastname: Kang
authors.affiliation: Department of Rehabilitation Medicine, Pulmonary Rehabilitation Center, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Korea .
authors.forename: Won Ah
authors.identifier: 0000-0003-0403-8869
authors.initials: WA
authors.lastname: Choi
authors.affiliation: Department of Rehabilitation Medicine, Pulmonary Rehabilitation Center, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Korea .
authors.forename: Han Eol
authors.identifier: 0000-0001-5625-3013
authors.initials: HE
authors.lastname: Cho
authors.affiliation: Department of Rehabilitation Medicine, Pulmonary Rehabilitation Center, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Korea .
authors.forename: Jang Woo
authors.identifier: 0000-0002-2634-0375
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Rehabilitation Medicine, Pulmonary Rehabilitation Center, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Korea .
authors.forename: Jung Hyun
authors.identifier: 0000-0003-3262-7476
authors.initials: JH
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D019468:Disease Management; D005260:Female; D006699:Home Care Services; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009468:Neuromuscular Diseases / Q000150:complications / Q000191:economics / Q000523:psychology*; D056910:Republic of Korea; D012131:Respiratory Insufficiency / Q000150:complications / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D012122:Ventilators, Mechanical
keywords: Home Care; Mechanical Ventilator; Neuromuscular Disease; Respiratory Insufficiency