Long-term mechanical ventilation refers to ventilatory assistance for patients who
require more than 6 hours of assisted ventilation daily for periods exceeding 21
days. Such patients include those unable to be liberated from mechanical ventilation
after bouts of acute respiratory failure as well as those with severe ventilatory
defects who undergo initiation of mechanical ventilation when they develop
respiratory insufficiency prior to a respiratory crisis. These patients comprise a
dynamic population; some succumb to their underlying illness or, occasionally,
to complications of ventilation—and new patients enter the group on a daily
basis. The number of such patients has been increasing steadily and their management
has undergone a steady evolution in response to new knowledge and technology
as well as changes in the insurance climate, which ultimately determines
what resources are available to them. The purpose of this book is to provide a
comprehensive and current reference for clinicians, reimbursement specialists,
and others in the mechanical ventilation field on the state of knowledge regarding
pathophysiology, clinical management, and reimbursement practices for longterm
mechanical ventilation.
Chapter 1 provides an international