TY - JOUR T1 - Impact of built-in software analysis on monitoring patients under home mechanical ventilation JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P3856 AU - Juan Cascón AU - Ramón Fernández AU - Andrés Quezada AU - Gemma Rubinos AU - Francisco R. Jerez AU - Claudio Rabec AU - Pere Casan Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P3856.abstract N2 - INTRODUCTION: Ventilators for Home mechanical ventilation (HMV) has built-in software (BIS) that provide information about patient-ventilator interaction that could improve patient's management.OBJECTIVE: To assess the impact of adding BIS to basic monitoring techniques (BMT) on the detection of unsatisfactory HMV.METHODS: Patients under HMV were included. BMT were: clinical interview, arterial blood gas (ABG) and home nocturnal oximetry (HNO). HMV was satisfactory (S-HMV) if the following criteria were met: 1-Comfort and improvement of symptoms, 2-ABG: pO2>60 mmHg and pCO2<46 mmHg, 3-HNO: SpO2 time < 90% (T90) < 20%, and 4-BIS analysis: compliance >4 h/night, respiratory rate <25 breaths/min, average leak <60 L/min (facial mask) and <50 L/min (nasal mask), and asynchronies in <50% of the whole record (pressure slope). HMV was unsatisfactory (U-HMV) if any of the criteria fail. Changes in treatment were recorded. Vivo 30/40 and their BIS were used in all cases.RESULTS: Fifty patients aged 60(9) yrs, 60% male and 21(7) months under HMV were included. Conditions were: 29 Obesity-hypoventilation, 5 chest wall disorders, 4 neuromuscular diseases, 4 COPD and 8 mixed conditions. Thirteen cases (26%) were S-HMV. Seventy-nine U-HMV causes were detected, 34 by BIS and 45 by BMT. Fifty-nine changes were made in 33 patients: 15 interfaces, 15 ventilator settings, 11 harnesses, 5 added humidifier, 5 added O2, 5 withdrew O2 and 3 changes of ventilator. BIS detected 12 (32%) of the 37 U-HMV cases with no abnormalities in BMT.CONCLUSIONS: Applying simple criteria to the analysis of ventilator BIS increases our ability to detect U-HMV and promotes changes that could improve the quality of treatment. ER -