Chest
Volume 114, Issue 5, November 1998, Pages 1363-1367
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Clinicai Investigations: Important Topics
Frequency, Causes, and Outcome of Home Ventilator Failure

https://doi.org/10.1378/chest.114.5.1363Get rights and content

Study objectives

The safety of home ventilators has been questioned. We collected data to study the following: frequency of home ventilator failure, apparent causes for the failure or malfunction, and adverse consequences following the failure.

Study design

Information on all requests to correct home ventilator failures reported to a home respiratory equipment vendor was collected prospectively between November 1991, and November 1992.

Patients

There were 150 ventilator-assisted patients aged 2 to 77 years; 44 were ≤ 18 years. They received 841,234 h of home mechanical ventilation (average, 15.4 h/d per ventilator-assisted patient).

Results

There were 189 reports of home ventilator failure. Defective equipment or mechanical failure was found in only 39% (73 reports), equivalent to one home ventilator failure for every 1.25 years of continuous use. Other causes of ventilator failure included the following: improper care, damage, or tampering with the ventilator by caregivers (13%), functional equipment improperly used by caregivers (30%), and equipment functional but the patient's condition changed, mimicking ventilator failure (3%). No problem could be identified in 16%. The following actions were required: ventilator replacement (44%), repair of a defective part (6%), replacement of a functioning ventilator for psychological comfort (14%), ventilator adjustments made (21%), caregiver reeducation (7%), caregiver anxiety or distress reduced (3%), and no action required (4%). Hospitalization was required only in two cases (1%). No adverse outcomes, deaths, or serious injuries were associated with home ventilator failure.

Conclusions

We conclude that in 150 patients requiring home mechanical ventilation, ventilator failure occurred relatively infrequently, and there were no adverse outcomes as a result of equipment failure at home. We speculate that equipment failure is not a frequent or serious problem for ventilator-assisted patients treated at home.

Section snippets

Materials and Methods

All patients who were receiving ventilator assistance at home, including children and adults, served by the Greater Los Angeles Branch of National Medical Homecare (NMC; Pasadena, CA) were included. The total number of patients served in the area were 150 children and adults with chronic respiratory failure who received a total of 841,234 h of assisted ventilation (average 5,608 h per ventilator assisted patient; or 15.4 h/d per ventilator-assisted patient). They ranged in age from 2 to 77

Results

There were a total of 189 cases of suspected ventilator failure reported to NMC during the year for 841,234 h of assisted ventilation (1 failure for every 1.25 years of continuous ventilator use). Of the 95 male patients receiving assisted ventilation, failures were reported in 57 (60%) as compared with 30 of 55 female patients (54%); p = 0.32, not significant. There were no significant differences in the proportion of patients reporting ventilator failures at different ages (Table 1).

Of the 69

Discussion

Our study showed that home ventilator failure occurred relatively infrequently in a population of 150 patients requiring home mechanical ventilation. Further, equipment failure was not a frequent or serious problem for these ventilator-assisted patients treated at home. In a 1-year period of time, there were a total of 189 reports of home ventilator failure in 150 patients. Ventilator failures were reported in patients of all age groups and in both sexes. There were no adverse outcomes from

ACKNOWLEDGMENTS

The authors thank the NMC Respiratory Therapists, Renee Moreno, RCP, Nadine Antunez, RCP, Joyce Moga, RCP, and Armando Rave, RCP, for completing ventilator failure reports for this study. We thank Ron Chamberlain for writing the computer program used to compile and analyze these data.

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