Προαγωγή της υγείας μέσω της κατ' οίκον νοσηλευτικής φροντίδας των ατόμων με χρόνια αποφρακτική πνευμονοπάθεια που χρησιμοποιούν το μη επεμβατικό αερισμό ; Helath promotion through the house in nursing care for people with chronic obstructive pulmonary disease using non invasive ventilation

Home care for terminally ill patients is increasing and its effect on prognosis is yet not definitely determined. The term Non-Invasive Mechanical Ventilation (NIMV) refers to the concept of respiratory support without need for an invasive artificial ventilation and it is used nowadays for respiratory failure management in home basis or in hospital. The aim of the study was to estimate short and long term survival in patients hospitalized for acute respiratory failure and identify the factors that contribute to a long term benefit from the use of ΝΙΜV for patients receiving home care. This was a retrospective study of 211 NIV patients consecutively hospitalized during 2007-2010. COPD and OHS were the major causes of respiratory insufficiency. The NIV was applied with a portable, noninvasive ventilator VPAP III ST with a mask. Inclusion criteria were : a) clinical signs and symptoms of acute respiratory distress: dyspnoea, respiratory rate less than 24 breaths per minute and use of auxiliary respiratory muscles and b) hypercapnic respiratory failure (acute or chronic) with PaCO2> 50 mmHg. Those patients who had any of the following were excluded: respiratory arrest, unstable condition(hypotension, uncontrolled cardiac ischemia / arrhythmia), inability to protect the airway (patient lethargic / comatose) and patients who were judged to be reluctant to cooperate. The diagnosis of COPD was made according to the entered instructions ATS / ERS (1995).Laboratory values and home support were recorded and their impact on two year prognosis was assessed. Their clinical status was indirectly assessed after telephone interviews with the patients themselves and their significant others. The follow- up was completed two years later. At the end of follow-up period, patients were evaluated at home by a specialized nurse. In case of multiple admissions the latest laboratory values were taken into account for assessing prognosis. From the 292 patients initially approached sixty patients refused receiving NIV, despite ...