Data Collection Protocol
An algorithm of the data collection protocol is shown in Figure 1. Baseline measurements of arterial blood gas tensions, respiratory mechanics, and functional status were obtained in all patients at VRU entry. All patients then underwent titration of pressure (BiPAP) or volume (PLV-102 ventilator) ventilators to achieve ventilation goals as previously outlined. The duration of NPPV use per day was increased in progressive fashion until patients were able to tolerate at least 6 h of NPPV treatment per night. During the patients’ stay in the VRU, they were evaluated by all members of the multidisciplinary team. Prior to discharge, patients and their families underwent additional NPPV instruction. At the time of discharge, repeat measurements of arterial blood gas tensions, respiratory mechanics, and functional score were obtained.
Patients were seen at home by a durable home equipment vendor and by a visiting nurse, and periodic phone calls were made by the VRU coordinator to discuss patients’ status and care plans. Patients were reexamined approximately every 4 to 6 weeks in the weekly outpatient clinic.
Measurements of arterial blood gas tensions, respiratory mechanics, and functional status were then repeated approximately 6 months after discharge. During the follow-up period, patients underwent adjustments in NPPV masks or ventilator settings if needed in order to maintain patient-ventilator synchrony and optimize gas exchange and functional status.
A one-way analysis of variance with repeated measures was used to compare ventilatory variables, and arterial blood gases on admission, at discharge, and during outpatient follow-up. Separate analyses were done between COPD and restrictive ventilatory disorder subsets. The Student’s t test was used to determine whether a significant relationship existed between respiratory mechanics before and after the institution of NPPV therapy. Demographic data are shown as mean ± SD; other results are expressed as mean ± SEM. A probability value of 0.05 was considered statistically significant. contraceptive pills
Figure 1. Algorithm of patient evaluation and treatment during the outpatient and inpatient phases of the study. ABG = arterial blood gases; O = COPD; R = restrictive ventilatory disorders; MIP = Pimax; MEP = PEmax; HCFA + Health Care Financing Administration; DEV = durable equipment vendor; VNA = Visiting Nurse Association.
Blog invites submissions of review articles, reports on clinical techniques, case reports, conference summaries, and articles of opinion pertinent to the control of pain and anxiety in dentistry.