Comprehensive management of ventilator-dependent patients: course report

Course organisers

Faculty

Overview

Approximately 13–20 million people worldwide require life support in intensive care units annually for various forms of critical illness. Progress in treatment has markedly improved the survival of these patients, at the price of increasing persisting physical disabilities in many survivors, associated with reduced quality of life, even years after the acute event, and an increase in partial or complete dependence on mechanical ventilation. The management of these patients requires specific skills by doctors, nurses, physiotherapists, and patients themselves and nonprofessional caregivers. The ERS is well aware of the educational needs of these growing problems, so for the first time, the Educational Council organised a 3-day postgraduate course on this subject. All the main issues of the topic were addressed in formal lectures and practical workshops, and discussed by 70 people from all over Europe, representing all professional skills and usually involved in the management of these patients. Formal discussion was fruitful and participants had the opportunity for further discussion with speakers during breaks, lunch times and a visit to the city. All speakers and participants were in favour of a new course on this topic in the near future.

Elena Fatnic, Republic of Moldova, a participant

“Comprehensive management of ventilator-dependent patients” was a comprehensive course. Theory was supplemented with suitable practical training. Participants received very structured information about the latest developments in the management of ventilator-dependent patients. In the theory sessions, many topics were discussed, ranging from pathophysiological problems, epidemiology of these patients, and long-term nutrition and home physiotherapy. In the practical workshops, we were all able to try new equipment for airway clearance management at home. On display were different ventilators intended for noninvasive home ventilation. We could change the settings on ventilators and discuss their advantages with moderators. I discovered new possibilities for telemedicine and telemonitoring.

There was a very friendly atmosphere at the course. Participants arrived from different countries with different lengths of service. Multilateral orientation made this course more attractive. There were both doctors and nurses from such specialities as pneumology, physiotherapy and intensive care, so I met a lot of great specialists with whom I was able to share our experience, during coffee breaks; the weaning centre and telemonitoring were the most controversial issues among participants.

In all countries, it is very difficult to wean a patient from hospital to home, and it is usual for the patient to occupy a bed in the intensive care unit (ICU) solely because of their dependence on pulmonary ventilation. Existence of the weaning centres may resolve this problem by releasing ICU places while providing good medical care at less cost. The benefit and use of such weaning centres and telemonitoring in home management of ventilator-dependent patients were the most discussed topics because these issues were very promising in a new approach to such patients.

This course inspired me to change aspects of my management of ventilator-dependent patients in my country. I learnt some modalities of airway clearance at home and how to train relatives to take care of such patients, and the importance of professional caregivers.

I want to thank the ERS for such an apposite and useful course!