Ventilation is the movement of air between the lungs and the atmosphere through a machine. A ventilator is a machine that provides oxygen to the lungs through a breathing tube. Usually, healthcare systems use mechanical ventilation as a short-term therapy for most patients. However, in some cases, weaning fails, and mechanical ventilation continues for considerably longer periods. Mostly, the patients suffering from acute respiratory distress syndrome (ARDS) need long-term ventilation because their lungs are filled with liquid making it impossible to breathe in oxygen.
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What is a Long-Term Ventilation Program?
The long-term ventilation program provides a more appropriate setting for ventilated patients to care for and manage their health. It is also a program to provide ongoing management and comprehensive consultation to ventilator-dependent patients.
Some Facts About Long-Term Ventilation
The number of long-term mechanical ventilation-dependent patients is increasing over time. The ongoing COVID-19 pandemic has boosted ventilator usage around the world. Still, less than 10% of patients require long-term ventilation. Do you know that
- The United States has more than 4800 children that rely on invasive ventilation
- America is a country with almost 11000 long-term ventilated patients
- The demand for tracheostomy tubes increased from 8.3 to 24.2 per 100,000 patients during 1993-2002
Medical research shows that less than 10% of patients with acute respiratory issues require long-term mechanical ventilation. However, they take up to 40% of space in intensive care units. Patients with neurological disorders and progressive respiratory diseases need lifelong ventilator support.
What Can We Expect from this Program?
The primary objective of a long-term mechanical ventilation program is to provide the patients with optimal care and also support their families to manage the patient. It also tells them the ways to get out of this challenging situation. LTV program offers much to the patients suffering from acute respiratory issues and increases their quality of life. Nowadays, every hospital that provides support to such patients offers something unique from others. The most critical care and support include:
- Inpatient and outpatient consultation services
- Therapies for proper clean up of airways
- Imparts training to the caregivers on how to use a ventilator at home
- Eases the transition between home treatment and intensive care unit treatment
- Collaboration and coordination with medical and surgical specialists
- Consistent follow up of the patient
All health care centers have medical specialists who always focus on finding ways to overcome acute respiratory issues. They provide both inpatient and outpatient treatments. However, we cannot overlook the role of rehabilitation to bring the patient to a normal lifestyle. It helps them regain or restore the functions that were affected due to respiratory issues. Rehabilitation helps them breathe independently as soon as possible.
How Long A Patient Has to Stay in Hospital During LTV Program?
No one can estimate how long a patient has to stay in the hospital during this program. It is always different for different patients depending on their mechanical ventilation period and the severity of the respiratory disease. However, reports show that patients remaining on ventilation for less than 21 days have to stay in ICU for 5-6 days.
On the other hand, the patients remaining on the ventilator for more than 21 days have to stay in ICU for 141-288 days. The patients having long-term in-hospital ventilation are long-term ventilated patients. Another study analyzes the patients’ readmissions to the hospital six months after their discharge.
Sometimes, readmissions depend on how long the patient had remained in the hospital earlier. In most cases, the patients were readmitted to hospitals 39 days after discharge. Readmission was more difficult for the patients who stayed on a ventilator for extended periods. The data collected showed the readmission of 38%. However, in some health care facilities, the duration of remaining on ventilators is reduced because of top-notch respiratory protocols. The experts recommend spontaneous breathing trials (SBTs) to judge the patients’ ventilator dependency. In case of low dependence, the patient could be a candidate for weaning.
Is There Any Possibility of Weaning Failure?
Yes, weaning can fail. The doctors recommend spontaneous breathing trials to judge the success or failure of weaning. Usually, the patients that need reintubation 48 hours after its removal indicate the failure of the weaning process. The healthcare professionals predict the success rate and recommend weaning only for those patients that meet the specific criteria. Here, it is pertinent to mention that reintubation rates are lower and remain between 10-15 percent.
Weaning for Patients on Ventilator
Weaning is the process of transmission of a patient from a ventilator to spontaneous breathing. The primary objective of the process is to shift the patient to normal breathing as soon as possible. Stats show that 20-30% of patients feel trouble in weaning from mechanical ventilation. Here, it is pertinent to mention that weaning can be different for different patients depending on the severity of the disease. Weaning makes a patient independent after rehabilitation.
Doctors have divided weaning into three categories depending on the duration it takes. These are simple, difficult, and prolonged weaning processes. Usually, simple weaning is mandatory soon after the patient leaves the ventilator. Difficult weaning takes a little longer time. The patients leave ventilators after 2-7 days of assessment. However, patients with acute respiratory conditions have to remain on a ventilator for prolonged periods. For most patients, it takes more than seven days after initial assessment.
Some Predictions About the Failure of Weaning
The healthcare professionals have highlighted different factors to predict the failure of the weaning program. Some of those are:
- Old age
- Chronic Illness
- Dependence on long-term mechanical ventilation, and
- Fluid balance
Age is the fundamental cause of weaning failure because aging reduces diaphragmatic function. The failure of weaning is sure if an aged man suffers from acute illness. It also increases the risk of muscle breakdown that takes a heavy toll on the lungs. Figures show that more than 50% of patients on ventilators have severe pulmonary issues.
In short, the condition of a patient’s respiratory system determines the failure or success of weaning. Patients with pneumonia, acute lung injury, interstitial lung disease, and pulmonary edema are more prone to weaning failure. Similarly, the patients who remain on mechanical ventilation for extended periods experience weaning failure.
Summary
Mechanical ventilation is a life-saving treatment for patients suffering from acute respiratory issues. It relaxes them and allows the weakened muscles to regain strength and get back on spontaneous breathing.
Why CMRC?
CMRC Hospital is the specialized provider for Long-term Care and rehabilitation services in Saudi Arabia. With one main facilities in Saudi Arabia, which are designed in a rehabilitation and long-term care hospital with a capacity of 66 beds.
CMRC provides an interdisciplinary clinical approach for Vent Rehabilitation Services which is customized for adults, adolescents, and children. The best rehabilitation services are not only our goal but our ultimate objective is to customize the care plan for each patient and make sure that the patient’s family and their members are integrated into the treatment plan.
When you joined Saudi Arabia hospital for any kind of our rehabilitation services or even for long-term care you will feel as if you are at #Your Second Home.
