Patients on home mechanical ventilation (HMV) are ventilator dependent, usually for the rest of their lives. In the past decades, the number of patients on HMV increased to nearly 3,000 in 2016 in the Netherlands. Current indications for HMV are patients diagnosed with either neuromuscular disease, spine deformities, lung disease or sleep apnea. Improving the quality of life by reducing the complaints of chronic respiratory failure is the ultimate goal for HMV. In the Netherlands patients have to be admitted to the hospital for the initiation of HMV. In the thesis titled "Innovation in home mechanical ventilation", Anda Hazenberg describes three innovations, the most important being the initiation of HMV at home by using telemonitoring. In a randomized controlled trial, she shows that the initiation of HMV at home is safe, feasible, effective also on quality of life and that in addition over € 3,000 per patient can be saved. A second innovation, is the assessment of carbon dioxide and oxygen levels through the skin with a sensor placed on the earlobe. She shows that is feasible and useful for the initiation of HMV, greatly reducing the need for blood sampling by needles. The stimulation of the diaphragm by using an external pacemaker is the third innovation and this seems to be effective in patients with a high spinal cord injury.
In her thesis, Hazenberg shows that clinical research, combined with technical innovations, improves the care of patients on HMV while potentially reducing costs.