• Sven Stieglitz, Sandhya Matthes, Ilona Kietzmann, Christina Priegnitz, Lars Hagmeyer, and Winfried Randerath.
• Medical Department I, Petrus Hospital Wuppertal, Academic Teaching Hospital of the University of Duesseldorf, Wuppertal, Germany.
• Clin Respir J. 2018 Apr 1; 12 (4): 1447-1453.

ObjectivesThe number of ventilated patients is further increasing which leads to an increasing number of patients with weaning failure. In Germany, the treatment of patients with invasive out-of-hospital becomes more and more common. The aim of the study was to observe the outcome, the frequency and character of emergencies of patients with invasive out-of-hospital ventilation.MethodsWe conducted a prospective study over 1 year. Fifty-nine invasively ventilated patients living either at home or at nursing homes specialized in ventilator medicine were included.ResultsForty-one (71%) of the patients were living in a nursing home. Chronic obstructive pulmonary disease (COPD) was the most common underlying disease (52.5%). Duration of daily ventilation did not change over the 1-year period. 52.8% of the months went without a documented emergency. The most common emergencies were oxygen desaturation (29.6%), increase of secretion (12.2%) and dyspnea (8.7%). We found no difference in the frequency of emergencies between patients cared for in their own home compared with residential care. Ten patients died during the observation period. Fewer emergencies (P = .02, CI 0.03-0.85) was the only parameter associated with a reduced mortality. Frequency of emergencies as well as survival showed no difference regarding the way patients were cared for.ConclusionsIn patients with invasive home mechanical ventilation survival for more than 1 year seems to be common. Only the rate of emergencies affected survival.© 2017 John Wiley & Sons Ltd.

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