Home invasive mechanical ventilation in Finland in 2015–2019

  1. Petra Kotanen1,2⇑,
  2. Hanna-Riikka Kreivi1,
  3. Aki Vainionpää3,
  4. Hannu Laaksovirta4,
  5. Pirkko Brander1 and
  6. Waltteri Siirala5
  1. 1HUH Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
  2. 2Doctoral Programme in Clinical Research, University of Helsinki, Helsinki, Finland
  3. 3Department of Rehabilitation, Seinäjoki Central Hospital, Seinäjoki, Finland
  4. 4HUH Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
  5. 5Department of Anaesthesiology and Intensive Care, Turku University Hospital and University of Turku, Turku, Finland
  1. Petra Kotanen, HUH Heart and Lung Center, University of Helsinki and Helsinki University Hospital, P.O. Box 372 (Haartmaninkatu 4), FI-00029 HUS, Finland ORCID ID 0000-0002-0470-2582. E-mail: petra.kotanen{at}hus.fi

Abstract

Introduction The prevalence of long-term invasive mechanical ventilation via tracheostomy in chronic respiratory insufficiency is largely unknown. We aimed to clarify prevalence and aetiology of the use of home invasive mechanical ventilation (HIMV) in Finland in 2015–2019.

Methods Information on HIMV patients was collected yearly from all Finnish Hospital District patient registries between 1 January 2015 and 1 January 2019. Data included underlying diagnosis, time from diagnosis to HIMV initiation, treatment length, mortality and basic socio-demographic data.

Results In 2015, we had 107 HIMV patients. During the follow-up we received 34 new patients (24.1%) and 46 patients (32.6%) died. In 2019, we had 95 HIMV patients and the prevalence in Finland was 2.0/100 000. The most common diagnoses were motor neuron disease (29.1%) and spinal cord injuries (19.9%). Mean duration of HIMV among all patients on 1 January 2019 was 12.3 years and among deceased patients 11.2 years. Treatment durations ranged from motor neuron disease patients’ 7.7 years to post-polio syndrome patients’ 47.3. Most patients (81.6%) used HIMV 24 h·day−1.

Conclusions HIMV is a rare, long-lasting treatment, most often used in chronic hypoventilation caused by chronic neurological disease. Based on our 4 year follow-up the prevalence of HIMV seems to be diminishing in Finland. Treatment duration and survival vary greatly depending on the underlying diagnosis. Most of the patients were totally dependent on HIMV, requiring 24 h care.

Footnotes

This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.

Conflict of interest: Dr. Kotanen reports grants from The Finnish Anti-Tuberculosis Association, grants from The Research Foundation of Pulmonary Diseases in Finland, grants from The Väinö and Laine Kivi Foundation, grants from The Governmental subsidy for health sciences research, during the conduct of the study.

Conflict of interest: Dr. Kreivi has nothing to disclose.

Conflict of interest: Dr. Vainionpää has nothing to disclose.

Conflict of interest: Dr. Laaksovirta has nothing to disclose.

Conflict of interest: Dr. Brander has nothing to disclose.

Conflict of interest: Dr. Siirala has nothing to disclose.

This is a PDF-only article. Please click on the PDF link above to read it.

  • Received April 27, 2020.
  • Accepted August 31, 2020.
http://creativecommons.org/licenses/by-nc/4.0/

This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.