Home mechanical ventilation in adults: Clinical practice recommendations from the Portuguese Respiratory Society home mechanical ventilation assembly

<b>Background:</b> The use of home mechanical ventilation (HMV) has been increasing worldwide, driven by widening of clinical applications and improved patient survival rates. In Portugal, recent data indicate an even faster growth, although national HMV recommendations have remained unchanged for 25 years. <b>Research question:</b> We aimed to provide an update in clinical practice guidelines for HMV in adults, applicable to the Portuguese context, grounded on the latest available evidence and experts' opinion. <b>Study design and methods:</b> A multidisciplinary panel with experience in HMV in the adult population was assembled. A comprehensive literature search was conducted during March 2023 regarding specific topics: equipment, ventilatory modes and interfaces, HMV initiation, follow-up and monitoring, disease specificities (neuromuscular diseases, obesity-hypoventilation syndrome, restrictive chest wall diseases; chronic obstructive pulmonary disease, and other diseases), home mechanical invasive ventilation, and palliative and end of life care. A 2-round Delphi process was conducted to establish consensus among panel members. A minimum agreement threshold of 80% was required. <b>Results:</b> Out of 88 recommendations initially included in the Delphi process, 61 were selected by consensus. <b>Conclusion:</b> Final recommendations grounded in the current level of evidence are outlined, and the key limitations and proposals for future research are discussed.

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Journal
Pulmonology
Published
2025-12-22
DOI
https://doi.org/10.1080/25310429.2025.2598915
Primary Topic
Respiratory Support and Mechanisms
Type
article
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article

Home mechanical ventilation in adults: Clinical practice recommendations from the Portuguese Respiratory Society home mechanical ventilation assembly

A L Vieira, P Pinto, Mafalda van Zeller, C. Cristóvão et al.
Pulmonology
Respiratory Support and Mechanisms
article

Home mechanical ventilation in adults: Clinical practice recommendations from the Portuguese Respiratory Society home mechanical ventilation assembly

A L Vieira, P Pinto, Mafalda van Zeller, C. Cristóvão, Cristina Jácome, Lucía López Méndez, João Cravo, Ana Cysneiros, Margarida Barata, Joana Lages, Barbara Carneiro Seabra, M Torres Redondo, Mónica Grafino, Carla Maria Leite Nogueira, Helena Ramos, Célia Durães, N. Faria, Maria Jacob, Filipe Gonçalves, Cláudia Ribeiro, Diva Ferreira, Alexandra Carreiro, Guia Miguel, Margarida Aguiar, Paula Pamplona, Maria João Araújo, Margarida Raposo, Karl Cunha, Márcia Araújo, Miguel R. Gonçalves, Rita Gomes, Daniela Rodrigues, Cláudia Pimenta, Bebiana Conde, Sara Conde, João Paulo Silva, Marta Drummond, Pedro Viegas, Cidália Rodrigues
article en

Abstract

<b>Background:</b> The use of home mechanical ventilation (HMV) has been increasing worldwide, driven by widening of clinical applications and improved patient survival rates. In Portugal, recent data indicate an even faster growth, although national HMV recommendations have remained unchanged for 25 years. <b>Research question:</b> We aimed to provide an update in clinical practice guidelines for HMV in adults, applicable to the Portuguese context, grounded on the latest available evidence and experts' opinion. <b>Study design and methods:</b> A multidisciplinary panel with experience in HMV in the adult population was assembled. A comprehensive literature search was conducted during March 2023 regarding specific topics: equipment, ventilatory modes and interfaces, HMV initiation, follow-up and monitoring, disease specificities (neuromuscular diseases, obesity-hypoventilation syndrome, restrictive chest wall diseases; chronic obstructive pulmonary disease, and other diseases), home mechanical invasive ventilation, and palliative and end of life care. A 2-round Delphi process was conducted to establish consensus among panel members. A minimum agreement threshold of 80% was required. <b>Results:</b> Out of 88 recommendations initially included in the Delphi process, 61 were selected by consensus. <b>Conclusion:</b> Final recommendations grounded in the current level of evidence are outlined, and the key limitations and proposals for future research are discussed.

PulmonologyVol. 31(1)
University of Pisa (IT), University of Lisbon (PT), University of Trás-os-Montes and Alto Douro (PT), Universidade do Porto (PT), University of Occupational and Environmental Health Japan (JP), Hospital Pulido Valente (PT), Amyotrophic Lateral Sclerosis Association (US), Hospital de São João (PT), Hospital Padre Américo (PT), Mongolian National University of Medical Sciences (MN), Hospital da Senhora da Oliveira Guimarães (PT), Ação Educativa (BR), Centro Tecnológico das Indústrias Têxtil e do Vestuário de Portugal (PT), Instituto Português de Oncologia Francisco Gentil (PT), Hospital de Egas Moniz (PT), Hospital Pedro Hispano (PT), Vetenskap I Skolan (SE), Nova Medical (United States) (US), Hospital do Divino Espírito Santo (PT), Algarve Biomedical Center (PT), Clínica Santa María (CO), Hospital de Santo António (PT), Hospital da Luz (PT), Hospital Beatriz Ângelo (PT), Instituto de Saúde (BR), Decision Sciences (United States) (US), Hospital Braga (PT), Ourofino Saúde Animal (Brazil) (BR), Centro Hospitalar do Porto (PT), Hospital de São Sebastião (PT), i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto (PT), Institute of Biomedical Science (GB), University of Aveiro (PT), University of Algarve (PT), University of Coimbra (PT), Lourdes University (US), University of Minho (PT)
Openalex Percentile: Top 29%
Respiratory Support and Mechanisms
DOIOpen Access PDFOpenAlex
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