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Quality Control for Home Ventilators Inadequate

Ventilator settings sometimes incorrect, alarms sometimes nonfunctional

FRIDAY, May 5 (HealthDay News) -- The actual settings on home mechanical ventilators sometimes differ from the prescribed settings, and alarms sometimes do not work, according to a report in the May issue of Thorax.

Ramon Farre, Ph.D., of Universitat de Barcelona-IDIBAPS in Spain, and colleagues studied 290 elderly patients receiving home mechanical ventilation. A specially trained nurse visited the patients' homes over a four-month period to assess the prescribed versus actual settings on the ventilator control panel and the performance of the ventilator, and to test the ventilator alarms.

The researchers found that the mismatch between prescribed and actual delivered pressure or volume was about 10 percent. Alarms for power failure failed in 0.9 percent of the 225 ventilators with this feature, alarms for obstruction failed in 5.1 percent of 157 ventilators, and alarms for disconnection failed in 18.6 percent of 280 ventilators. However, there was no correlation between ventilator performance or alarm problems and hospital admissions in the previous year, according to the study.

"This study illustrates the current limitations of the quality control of home mechanical ventilation and suggests that improvements should be made to ensure adequate ventilator settings and correct ventilator performance and ventilator alarm operation," Farre and colleagues conclude.

In an accompanying editorial, Anita K. Simonds, M.D., of Royal Brompton Hospital in London, notes that "a key part of any home care program should be education of patients, families, and carers to help them use the equipment confidently and safely and to have a sensible plan of action once a problem arises."

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