Frustranes Weaning: Nachsorge durch das Weaningzentrum – Hausbesuche bei invasiv beatmeten Patienten

Abstract

At present health-care at home for the majority of patients with invasive ventilation is mainly provided by nursing personnel. The reason for this unsatisfying condition is the lack of a basic medical supply for patients with invasive ventilation outside of hospitals. In contrast, current guidelines recommend a follow-up care by the weaning centres that applies for patients with invasive ventilation at home. In an case the practical implementation of the follow-up care is not specified. In this paper we attempt to balance the reasons for the need of follow-up care for ventilated patients by the weaning centre on the basis of 6 cases. Furthermore, we want to report our experience with a weekly visitation of these patients as a basic structure of the follow-up care. The necessity for a regular consultation by a pneumologist that can be established by weekly rounds has been demonstrated. In addition, it can be expected to reduce the costs of public health markedly if one takes data from ventilated patients living in specialised institutions into account. Nevertheless prospective studies are necessary to objectify the financial and medical benefits arising from this form of medical supply. These studies should be designed as multicentre studies because of the heterogenous population of ventilated patients and the fact that home ventilation is in general a seldom occurrence.