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Patients who fail to maintain adequate respiration may need long-term mechanical ventilation (LTMV) in shorter or longer periods. Patients using LTMV constitute a heterogeneous group with respect to age, diagnoses and disease progression. Norwegian data suggests considerable regional differences in the use of LTMV. Commission The Norwegian Directorate of Health recently prepared new guidelines for the use of LTMV outside hospitals. The Norwegian Knowledge Centre for Health Services was commissioned to prepare a systematic review on the efficacy of LTMV. This is the first of three reviews, and here we summarize evidence on the effectiveness of LTMV for patients with neuromuscular disorders and for patients with central respiratory failure. Main results1. LTMV may be associated with some degree of life extension and improved quality of life for patients with amyotrophic lateral sclerosis, at least for patients with good bulbar function. The quality of evidence is low, and it is not possible to draw firm conclusions about the real effect.2. LTMV can be associated with life extension among hypoventilated patients with Duchenne muscular dystrophy, but the quality of evidence is low, and it is not possible to draw firm conclusions about the real effect.3. Across patients with various neuromuscular diagnoses, it seems that LTMV may be associated with fewer hospital admissions, and that invasive LTMV is associated with greater risk of complications and hospitalization than non-invasive LTMV. The quality of evidence is low, and we can not draw firm conclusions about the real effect.4. For some diagnoses, for example central respiratory failure, we were not able to identify any research fulfilling our inclusion criteria.
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Patients who fail to maintain adequate respiration may need long-term mechanical ventilation (LTMV) in shorter or longer periods. Patients using LTMV constitute a heterogeneous group with respect to age, diagnoses and disease progression. Norwegian data suggests considerable regional differences in the use of LTMV. Commission The Norwegian Directorate of Health recently prepared new guidelines for the use of LTMV outside hospitals. The Norwegian Knowledge Centre for Health Services was commissioned to prepare a systematic review on the efficacy of LTMV. This is the first of three reviews, and here we summarize evidence on the effectiveness of LTMV for patients with neuromuscular disorders and for patients with central respiratory failure. Main results1. LTMV may be associated with some degree of life extension and improved quality of life for patients with amyotrophic lateral sclerosis, at least for patients with good bulbar function. The quality of evidence is low, and it is not possible to draw firm conclusions about the real effect.2. LTMV can be associated with life extension among hypoventilated patients with Duchenne muscular dystrophy, but the quality of evidence is low, and it is not possible to draw firm conclusions about the real effect.3. Across patients with various neuromuscular diagnoses, it seems that LTMV may be associated with fewer hospital admissions, and that invasive LTMV is associated with greater risk of complications and hospitalization than non-invasive LTMV. The quality of evidence is low, and we can not draw firm conclusions about the real effect.4. For some diagnoses, for example central respiratory failure, we were not able to identify any research fulfilling our inclusion criteria.
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Contracting out --- Letting of contracts --- Evaluation. --- Government policy --- American Medical Equipment Company.
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Contracting out --- Letting of contracts --- Evaluation. --- Government policy --- Evaluation. --- American Medical Equipment Company.
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Biomedical engineering --- Biomedical Engineering --- Biotechnologie --- Biotechnology --- Sciences médicales --- medical sciences --- Génie biochimique --- biochemical engineering --- Biologie moléculaire --- Molecular biology --- Equipement médical --- Medical equipment --- Imagerie --- Imagery --- Physiologie humaine --- Human physiology
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Respiration artificielle --- Respirateurs médicaux --- Appareil respiratoire --- Respiration, Artificial. --- Respiration Disorders --- Ventilators, Mechanical. --- Maladies --- thérapeutique --- therapy --- Artificial respiration. --- Respirators (Medical equipment). --- Respiratory therapy. --- therapy. --- Respiration artificielle. --- Respirateurs médicaux. --- thérapeutique. --- Respiration, Artificial --- Ventilators, Mechanical
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Given the widespread use of polymers in medical devices, the durability and reliability of this material in use is an area of critical importance. Durability and reliability of medical polymers reviews the performance of both bioresorbable and non-bioresorbable medical polymers.Part one provides a review of the types and properties of bioresorbable medical polymers. The effect of molecular structure on properties is discussed, along with the processing of bioresorbable and other polymers for medical applications. Transport phenomena and the degradation of bioresorbable medical polymers
Polymers in medicine. --- Polymers. --- Polymers in medicine --- Equipment and Supplies --- Biomedical and Dental Materials --- Investigative Techniques --- Macromolecular Substances --- Chemicals and Drugs --- Analytical, Diagnostic and Therapeutic Techniques and Equipment --- Manufactured Materials --- Technology, Industry, and Agriculture --- Technology, Industry, Agriculture --- Durable Medical Equipment --- Polymers --- Equipment Failure --- Health & Biological Sciences --- Biomedical Engineering --- Biomedical polymers --- Medical polymers --- Biomedical materials --- Medical instruments and apparatus
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