ABSTRACT
In contrast to some countries, the polio epidemics of the 1950s did not trigger the initiation of long-term ventilation (LTV) in Japan (1). The first patient to receive LTV at home was in Tokyo in 1975, when an adult with neuromuscular disease (NMD) received tracheal invasive positive pressure ventilation (TIPPV) (2). Despite the introduction of public assistance for costs associated with home mechanical ventilation (HMV), fewer than 200 patients were receiving HMV between 1990 and 1993 (Fig. 1) (2).
