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Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
Vmd catalunya 25 05 2010
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Vmd catalunya 25 05 2010

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Sessió Clínica a l'Hospital del Mar (Barcelona)

Sessió Clínica a l'Hospital del Mar (Barcelona)

Published in: Health & Medicine
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  • 1. Ventilació mecànica a domicili Barcelona, 25 de maig de 2010 Origens i perspectiva actual Dr. Joan Escarrabill Pla Director de les Malalties Respiratòries (PDMAR) Institut d’Estudis de la Salut Barcelona [email_address]
  • 2. L’epidèmia de poliomielitis Lassen. Lancet 1953;i:37-41.
  • 3. ...dels pacients amb IRA no podien abandonar el ventilador 10% Kinnear Br J Dis Chest 1985;79:313-51 Bertoye. Lyon Médical 1965;38:389-410.
  • 4. VMD traqueo CPAP Sullivan Lancet 1981 Robert. Rev fr Mal Resp 1983;11:923-936. Brocard L. N Engl J Med. 1990;323:1523-30 . Ventilació: de la polio a casa i a la UCI
  • 5. VMD: els primers passos Nogueras. Med Clin (Barc) 1985;84:333-4 . Pacient Respirador Mark 7 Oxígen Aigua (humidificació) Montserrat. Respiration 1988;53:128-131
  • 6. Estopà. Arch Bronconeumol 1988;24(supl 1);64 1987 Juny 1988 “ Poncho” Traqueotomía Escarrabill. Arch Bronconeumol 1990;26:375-6 Ventilació amb pressió negativa i ventilació invasiva
  • 7. Ventilació no invasiva NIV Escarrabill. Med Clin (Barc) 1991;97:421-423 Nov 1988 Masa. Arch Bronconeumol 1991;27:290-4
  • 8. Arch Bronconeumol 2000;36:545-50 Font: F. Crespo, Vitalaire (2006) ¿ 5000 ? 34 8 228 39 632 13 146 134 1160 546 230 1034 487 63 139 Any d’inici de la VMD
  • 9. Year of starting HMV >50% after 90’s Eur Respir J. 2005;25:1025-31. HMV before 80’s
  • 10. Eur Respir J. 2005;25:1025-31. Centres patients on HMV Service funding by the government or the NHS 329 21.526 Mean prevalence: 6.6 pts/10 6 inhab
  • 11. HMV: Financial issues Tax-funded Social-insurance-funded
  • 12. Diagnostics Eur Respir J. 2005;25:1025-31. Neuromuscular Chest wall Airway
  • 13. Diagnostics: airway vs prevalence Eur Respir J. 2005;25:1025-31.
  • 14. Patient & Caregiver Training Source: Eurovent Survey Patients Caregivers Is training crucial before discharge? 97% 84% Is there a continued training after discharge? 36% 34%
  • 15. Characteristics of care Source: Eurovent Survey 49% without home care
  • 16. HMV in neuromuscular disases (NMD) in Catalonia Prevalence / 100.000 hab Departament de Sanitat i Seguretat Social. Consell Assessor de Malalties Neuromusculars. 2001 Patients with NMD and HMV Health Regions
  • 17. Oupatient vs hospital initiation of NIV Chatwin et al. Respir Med 2008;102:1528-35. Luján et al. Respir Med 2007; 101:1177-82. Domenech-Clar et al. Respir Med 2008;102:1521-7 7 days 6 days 3.8 days Training: 1,2 + 0,4 sessions Admission days in the control group Feasible in selected patients Little impact on the availability of beds n=28 n=16 n=42
  • 18. Follow-up Escarrabill J. Breathe 2009;6:37-42. Population: 291.500.000
  • 19. Escarrabill J. www.ers-education.org/ JIVD 2009 Eurovent 2002
  • 20. Respir Med 2007;101:1068-1073 A = Acute E = Elective n = 43 Age = 77 + 1.9 yrs Compliance : 8.3 + 3.1 hrs/day 9% 4,8% 11% Patients < 75 yrs: 2% 6 years
  • 21. Escarrabill J. Breathe 2009;6:37-42.
  • 22.
  • 23. VMD i el PDMAR

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