ABSTRACT
P75 Figure 1Home ventilation delivery and dependence[Figure omitted. See PDF]ConclusionsThe apparent association between home non-invasive ventilator dependence and increased mortality in the second year of COVID-19 in the UK warrants investigation of unmet need in this patient group, compared with the invasively ventilated. Targeted review is planned in the local setting, facilitated by utilisation of home ventilation registry as a method of population surveillance.ReferencesLloyd-Owen SJ, et al. Patterns of home mechanical ventilation use in Europe: results from the Eurovent survey. ERJ 2005;25: 1025–1031.Allen M. Respiratory Medicine: GIRFT Programme National Specialty Report. London: GIRFT, 2021.
ABSTRACT
The COVID-19 pandemic had created havoc throughout the globe. Finding an appropriate vaccine is a surmount task for the medical professionals and scientists with a race against time. It had been found that the spread of infection and increase in number of deaths are exponential in nature in India and has created a panic situation. Nationwide lock-down and social distancing had resulted in various psychological problems like depression, anxiety and panic disorder. The pandemic had also caused severe threats to the lives and physical health of the people around the globe. In this pandemic time it is necessary to create an awareness campaign, so that people may be educated to take proper nutrition through appropriate diet and adopt other lifestyle measures, there by strengthening and improving their health and immune system. The emphasis of the paper was to highlight the role of micronutrients, proper dietary intakes and good sleep on health, which may help fight the invisible virus.
ABSTRACT
Introduction: There remains a paucity of data comparing ambulatory initiation of home non-invasive ventilation (NIV) with a model requiring inpatient admission. In our institution, a Quality Improvement (QI) project was performed where an ambulatory model for NIV initiation was developed and evaluated. Methods: Ambulatory pathways were formulated for NIV initiation in the outpatient setting, alongside outreach and initiation of NIV for inpatients referred within regional hospitals. The primary outcome measure was 'compliance with NIV' defined as NIV use ≥4 hours/night for ≥75% of nights. Results: Between 6.1.20 and 1.7.20, 76 referrals for home NIV were assessed within the ambulatory model. Of these, NIV was not indicated in 3 cases and contraindicated in 1 case, while 2 trialled NIV and declined it, leaving 70 patients who commenced home NIV (n=36 following COVID-19 ward 'closure'). Neuromuscular disease was the principal diagnosis in 41% (29/70) with MND comprising 20/29 neuromuscular cases;see table 1. Ventilator interaction data was available for 68 patients where mean NIV use was 5.21 (SD 3.98) hours/night. Of those established by ambulatory pathway, 62% (42/68) were deemed 'compliant' with NIV in comparison to previous data reporting compliance in 62% (56/90) of subjects established through inpatient admission. It was calculated that delivery of the ambulatory pathway resulted in a cost saving of £197,967 (Table presented) for this period, achieved principally by admission avoidance based on previous length of stay data and Level 2 bed costings. Conclusions: An ambulatory model for initiation of home NIV appears to be as effective in achieving compliance as inpatient admission, while carrying health economic benefits. Ambulatory treatment pathways enabled us to deliver service continuity during the COVID-19 pandemic.