Editorials

Home mechanical ventilation

BMJ 2011; 342 doi: http://dx.doi.org/10.1136/bmj.d1687 (Published 06 April 2011) Cite this as: BMJ 2011;342:d1687
  1. Matt P Wise, consultant in adult critical care1,
  2. Nicholas Hart, chairman2,
  3. Craig Davidson, clinical lead for home mechanical ventilation3,
  4. Rik Fox, clinical lead for home mechanical ventilation 4,
  5. Martin Allen, clinical lead for home mechanical ventilation5,
  6. Mark Elliott, clinical lead for home mechanical ventilation6,
  7. Bob Winter, president7,
  8. Mike Morgan, chairman8,
  9. Helena Shovelton, chief executive9,
  10. Robert Meadowcroft, chief executive10,
  11. Jane Campbell, independent cross-bench peer11,
  12. Ilora Finlay, president12
  1. 1British Thoracic Society Respiratory Critical Care Group, Adult Critical Care, University Hospital of Wales, Cardiff CF14 4XW, UK
  2. 2British Thoracic Society Respiratory Critical Care Group, National Institute of Health Research, Comprehensive Biomedical Research Centre, Guy’s and St Thomas’ NHS Foundation Trust and King’s College London
  3. 3Lane Fox Respiratory Unit, Guy’s and St Thomas’ Foundation Trust, London, UK
  4. 4Royal National Orthopaedic Hospital, Stanmore, UK
  5. 5University Hospital of North Staffordshire City General Site, Stoke-on-Trent, UK
  6. 6St James’s University Hospital, Leeds, UK
  7. 7Intensive Care Society, Nottingham University Hospitals NHS Trust, Nottingham, UK
  8. 8British Thoracic Society, Department of Respiratory Medicine, University Hospitals of Leicester, Glenfield Hospital, Leicester, UK
  9. 9British Lung Foundation, London, UK
  10. 10Muscular Dystrophy Campaign, London, UK
  11. 11House of Lords, London, UK
  12. 12Chartered Society of Physiotherapy, London, UK
  1. mattwise{at}doctors.org.uk

National registries are needed to reduce variations in care and improve patient safety

More than 140 000 critically ill patients are admitted to intensive care in England and Wales each year. Delayed weaning (>14 days) and continued dependence on mechanical ventilation occur in 2-5% of these people. The human and financial costs of this dependence are substantial.1 2 3 4 Although most patients are eventually weaned, the rest remain dependent on ventilation, which is provided through a tracheostomy or non-invasively by a mask or cuirasse.3 Such patients require assessment for home ventilation and often need an extensive care package that provides long term medical, nursing, and physiotherapy support.

Home ventilation and weaning units are best placed to coordinate this kind of care, although direct responsibility for the patient may switch to the community at hospital discharge. Such centres can also provide continuing support to patients at home, train carers, assess competency, and provide emergency support at times of crisis.1 In many parts of the United …

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