Projectdetails

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COVID-19 voor kwetsbare patienten afhankelijk van chronische beademing: wat waren de consequenties?

Keywords:
survey Home mechanical ventilation COVID-19

Researchers:
Prof. dr. M.L. Duiverman

Type of project:
Stage Wetenschap / Researchproject of MD/PhD programme

Nature of the research:
cohort

Fields of study:
pulmonology Patient Related Research

Background / introduction
Home mechanical ventilation (HMV) is an established therapy with increasing number of indications in different diseases leading to chronic respiratory failure. In many centers HMV was initially mainly used in patients with neuromuscular diseases (NMD). More recently, the use of and evidence for home noninvasive ventilation (NIV) has grown substantially in patients with obesity hypoventilation syndrome (OHS) and chronic obstructive pulmonary disease (COPD).(1-3) Also, the prevalence of pediatric HMV has increased, and more ventilator dependent children are transitioning to adult care.(4)

When in February 2020 the COVID-19 pandemic emerged, the situation changed for patients on HMV. First, patients and healthcare providers were afraid that COVID-19 would hit this population hard, as patients on HMV are already in a vulnerable respiratory situation in the chronic state. Second, there was a fear for aerosol spread due to the use of ventilation at home and thus increased risk for viral spread among caregivers when patient were infected. Therefore, it seemed that patients were taking the social distancing and isolation rules very seriously, which might have led to social isolation and feelings of loneliness.(5) Finally, the care for patients on HMV changed. The 4 HMV centers in the Netherlands (6) changed their practices; home visits and outpatients visits were replaced by telephone calls and video consultations and more patients were initiated on HMV at home instead of the hospital. This was regarded necessary to minimize contacts and as personnel of the HMV centers was ask to work on the ICU and COVID wards. However, we have shown before that dedicated home care is non-inferior to hospital care (7-9).
Research question / problem definition
The aim of this project is to get data on the “side-effects” of COVID-19 pandemic in this group, such as social isolation and diminished follow-up of their therapy by sending around a survey among all patient on HMV in the Netherlands.
Workplan
Questionnaires have been developed that are ready to be send around by e-mail. Responses will be collected in RedCAP. The student will arrange the distribution of the questionnaires and will analyse the results of the returned questionnaires. also he/she will dive into the EPD to connect there answer to objective measures of efficacy of therapy.
References
5. Cantero C, Pasquina P, Dao MD, Cedraschi C, Adler D, Plojoux J, Janssens JP. Impact of Confinement in Patients under Long-Term Noninvasive Ventilation during the First Wave of the SARS-CoV-2 Pandemic: A Remarkable Resilience. Respiration. 2021;100(9):909-917. doi: 10.1159/000516327. Epub 2021 Jun 15. PMID: 34130277; PMCID: PMC8339039.
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