# Home mechanical ventilation: a narrative review and a proposal of practical approach

## TL;DR

This paper reviews home mechanical ventilation and offers practical guidance for physicians to safely prescribe and manage it in patients with chronic respiratory failure.

## Contribution

The paper proposes a practical approach for implementing home mechanical ventilation, tailored to individual patient needs.

## Key findings

- Home mechanical ventilation is increasingly used for complex respiratory failure cases due to technological advances.
- Physicians need proper training to avoid inappropriate ventilation choices with ethical and legal risks.
- The paper lists available ventilator brands and models in Brazil and provides criteria for equipment selection.

## Abstract

Growing evidence of the benefits of home ventilatory support in patients with chronic respiratory failure along with technological advances in ventilators have enabled their use in overly complex situations, shaping a new scenario for physicians. This has further given rise to new challenges related to their incorporation into current medical practice. However, this evolution needs to be coupled with knowledge and skills of physicians who are willing to prescribe Home Mechanical Ventilation (HMV), in order to prevent them from making inappropriate choices or adjustments that may ultimately have ethical and legal implications. This article aims to provide guidance and information to support the indication for HMV and the ventilation modalities to be implemented, review basic ventilation concepts, including the ventilator modes most commonly used in patients outside the hospital setting, list the brands and models available in the Brazilian market, provide the means for obtaining equipment for HMV, and finally, describe the requirements for selection of equipment, taking into account the individual characteristics of the patient to ensure safe perioperative care and earlier dehospitalization.