Home telemonitoring of non-invasive ventilation decreases healthcare utilisation in a prospective controlled trial of patients with amyotrophic lateral sclerosis
Home telemonitoring of non-invasive ventilation decreases healthcare utilisation in a prospective controlled trial of patients with amyotrophic lateral sclerosis
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DOI：
10.1136/jnnp.2010.206680
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发表时间：
2010-11-01
影响因子：
11
通讯作者：
de Carvalho, Mamede
中科院分区：
文献类型：
--
作者：
Pinto, Anabela;Almeida, Jose Pedro;de Carvalho, Mamede
无创通气（NIV）是治疗肌萎缩侧索硬化症（ALS）患者呼吸衰竭的有效方法。然而，这需要一个适应过程，但由于遵守不力，这一过程并不总是能够实现。NIV远程监测的作用尚未确立。目的探讨现代通讯在渐冻症患者NIV中的优势。设计前瞻性、单盲对照试验。人群和方法：40例连续通气的ALS患者根据其居住地分为两组：对照组（G1, n=20），在办公室就诊时评估依从性和呼吸机参数设置；干预组（G2, n=20），患者接受连接呼吸机的调制解调器设备。在整个NIV使用期间的办公室和急诊室就诊次数和住院次数以及达到完全依从性的参数设置更改次数是主要的结果测量。结果两组患者入院时的人口学特征和临床特征相似。两组依从性无差异。在整个NIV生存期参数设置改变的发生率在G2组较低(p
Background Non-invasive ventilation (NIV) is an efficient method for treating respiratory failure in patients with amyotrophic lateral sclerosis (ALS). However, it requires a process of adaptation not always achieved due to poor compliance. The role of telemonitoring of NIV is not yet established.Objectives To test the advantage of using modem communication in NIV of ALS patients.Design Prospective, single blinded controlled trial.Population and methods According to their residence, 40 consecutive ventilated ALS patients were assigned to one of two groups: a control group (G1, n=20) in which compliance and ventilator parameter settings were assessed during office visits; or an intervention group (G2, n=20) in which patients received a modem device connected to the ventilator. The number of office and emergency room visits and hospital admissions during the entire span of NIV use and the number of parameter setting changes to achieve full compliance were the primary outcome measurements.Results Demographic and clinical features were similar between the two groups at admission. No difference in compliance was found between the groups. The incidence of changes in parameter settings throughout the survival period with NIV was lower in G2 (p