Long-term breathing via tracheostoma

Patients and Methods: From 1988 to 2/1997 we had introduced intermittent po sitive pressure ventilation (IPPV) in 298 patients. In most cases non-invas ive nasal mask ventilation was possible, in 21 patients (7%) a tracheostoma was necessary. These 21 patients were analysed retrospectively due to age, sex, diagnose, ventilation mode, course of illness, home care and costs. Results: We had 13 male and 8 female patients, aged 49 years on average (mi n. 2, max. 84). 90% had neuromuscular diseases especially muscle dystrophie s. Ventilation therapy was performed volume controlled with the cannula unb locked. during daytime and blocked at night. Eighteen patients had industri al cannulas (72% Shiley, 28% Rusch), 3 patients used silver cannulas. Daily ventilation amounted 24 hours in 7 patients, 6 to 14 hours in 14 patients. During the observed time 7 patients remained in stable health situation, i n 9 patients the underlying disease was progressive and 5 of them died. IPP V was performed 60.7 months on an average, in living patients 68.8 months, in died 7.6 months. Fifteen patients lived at home, 5 were cared in nursing home, 1 patient stayed in hospital. Outside the hospital the bigger part o f costs was paid by sick funds and care funds, the smaller part by social w elfare offices. Often costs were divided. Total costs for caring about 24 h ours ventilated patient at home amounted up to 21,000 German marks each mon th.