Figures
- FIGURE 1
Illustration of the complexity and intersectionality of modifiable and nonmodifiable influences on health-related quality of life in patients with chronic respiratory failure, some of which may be addressed using home mechanical ventilation.
- FIGURE 2
Questionnaires used to evaluate the impact of home mechanical ventilation (HMV) on health-related quality of life (HRQoL) [60, 66, 71–88].
- FIGURE 3
Health-related quality of life outcomes in clinical trials evaluating home mechanical ventilation (HMV) in patients with COPD, obesity and neuromuscular disease [10, 11, 17, 51, 98, 99, 102, 104, 112]. CCQ: Clinical COPD Questionnaire; CPAP: continuous positive airway pressure; CRQ: Chronic Respiratory Disease Questionnaire (higher score indicates better health); ESS: Epworth Sleepiness Scale (higher score indicates worse sleep quality); FOSQ: Functional Outcomes of Sleep Questionnaire (higher score indicates worse sleep quality); FSS: fatigue severity scale; NIV: noninvasive ventilation; OSA: obstructive sleep apnoea; PSQI: Pittsburgh Sleep Quality Index (higher score indicates worse sleep quality); SAQLI: Sleep Apnoea Quality of Life Index (higher scores indicate better health; SF-36: Short Form 36 (higher score indicates worse health); SGRQ: St George's Respiratory Questionnaire (higher score indicates worse health); SRI: Severe Respiratory Insufficiency Questionnaire (high score indicates better health); VAS: visual analogue scale (higher score indicates better health).
Tables
- TABLE 1
Chronic respiratory failure: an imbalance in respiratory muscle load, capacity and drive [2–5]
COPD Obesity-related respiratory failure Neuromuscular disease Respiratory muscle load • Airways inflammation and bronchospasm increasing airways resistance (RL)
• Sputum retention increases airways resistance (RL)
• Expiratory flow limitation results in intrinsic positive end expiratory pressure (TL)
• Emphysematous lung with loss of lung elasticity (EL)
• Upper airway obstruction (RL)
• Reduced chest wall compliance (EL)
• Early airway closure causing intrinsic positive end expiratory pressure (TL)
• Upper airway obstruction (RL)
• Sputum retention increasing airways resistance (RL)
• Reduced chest wall compliance (EL)
Respiratory muscle capacity • Lung hyperinflation impairing diaphragm contractility with preserved diaphragm strength
• Impaired diaphragm contractility caused by inflammation-related proteolysis
• Impaired gas exchange, increasing ventilatory demand
• Reduced respiratory muscle strength and expiratory reserve volume
• Respiratory muscle weakness
• Impaired chest wall excursion
NRD • Increased NRD inadequate for the load–capacity imbalance
• Increase NRD inadequate for the load–capacity imbalance
• Blunted hypercapnic ventilatory response
• Reduced and inadequate for the load–capacity imbalance
EL: elastic load; NRD: neural respiratory drive; RL: resistive load; TL: threshold load.
- TABLE 2
Classification of neuromuscular disease
Slowly progressive Nerve: • Spinal muscular atrophy
• Post-polio syndrome
• Guillain–Barré syndrome
• Myasthenia gravis
• Duchenne muscular dystrophy
• Becker muscular dystrophy
• Myotonic dystrophy
• Mitochondrial myopathies
• Charcot–Marie–Tooth disease
Rapidly progressive • Amyotrophic lateral sclerosis
