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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.

Respirators (Medical equipment)

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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.

Respirators (Medical equipment)

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This chapter explores the interrelationships between embodied knowledge and assistive technology. Its primary focus is on interwar developments to respiratory technologies in Britain, but explores more broadly the extent to which consideration of users and user involvement has featured in the design of various technologies to facilitate breathing. The chapter uses under-utilised primary sources from the National Archives and the Royal Institution to examine mechanical respirators such as the Bragg-Paul Pulsator, then develop this user-focused framework to consider the later rise of ambulatory oxygen for home use. Considering how users have mattered in respiratory assistive technology highlights the problems with prosthetic designs which fail to consider the full social worlds of the user. Understanding these problems necessitates awareness of the longer history of their development and the longer-term problems inherent to ownership of the air. This relates to the politics of nationalised healthcare because ambulatory oxygen was outsourced from NHS pharmacy control in 2006. The chapter therefore concludes with a discussion of how standardised technology currently affects diverse users' ability to engage with assistive technologies.

Respirators (Medical equipment)

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Artificial respiration --- Respirators (Medical equipment) --- Congresses. --- Congresses.

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Medicare --- Respirators (Medical equipment) --- Cost control. --- Fees