@article {KaesP4701, author = {Vanessa Kaes and Yahya Abazed and Gerhard Laier-Groeneveld}, title = {Equipment management in intensive care home mechanical ventilation}, volume = {44}, number = {Suppl 58}, elocation-id = {P4701}, year = {2014}, publisher = {European Respiratory Society}, abstract = {If routine change of the ventilator tubes, sterile tracheal suctioning, regular change in tracheal canula is beneficial in a home care setting is not known. Patients discharged from intensive care units to intensive care home mechanical ventilation in Germany follow the hygienic management of the discharging unit or the company providing home care. Therefore different home care settings can be studied on their effect on infections and exacerbations.Methods: A questionnaire was developed to investigate patients under invasive or noninvasive intensive care home mechanical ventilation and their caregivers for hygienic behavior and frequency of infections. Infections were defined either as infections judged by the patient or caregiver, period of antibiotic therapy or period of increased mucus secretions.Results: 214 patients and their caregivers returned the questionnaire. They reported 2.35 infections, 4.68 periods of increased secretion and 2.2 periods of antibiotic therapy per year in the overall group. Incidents were higher in COPD than neuromuscular disorders, higher during invasive than noninvasive ventilation and higher with higher PEEP but independent from ventilation pressure. Incidents were independent from change of HME, tracheal canula and sterile or nonsterile tracheal suctioning but higher with more frequent change of the ventilator tubes.Conclusion: In an intensive care home mechanical ventilation setting infective exacerbations are relevant. However a routine change of the tracheal canula, the HME and the ventilator tubes are not required. Tracheal suctioning should be performed clean but not steril. The ventilator setting using a high PEEP also has negative impact on the exacerbation rate.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/44/Suppl_58/P4701}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }