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“Can Intensive Care at Home wean a long-term Guillain–Barré patient in ICU with tracheostomy off the ventilator at home?” That is the question that I want to discuss today here on my channel.

My name is Patrik Hutzel from intensivecareathome.com, where we instantly improve the lives for families of critically ill patients in intensive care and we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies. We also provide tailor-made solutions for BIPAP (Bilevel Positive Airway Pressure), CPAP (Continuous Positive Airway Pressure) ventilated patients without tracheostomies, that’s adults and children, and where we also provide tailor-made solutions for tracheostomy clients, adults and children at home with tracheostomies. We provide cough assist management at home, nasogastric tube, nasojejunostomy (NJ) tube management at home, PEG (Percutaneous Endoscopic Gastrostomy) tube and PEJ (Percutaneous Endoscopic Jejunostomy) tube management at home, Home TPN (Total Parenteral Nutrition), home IV potassium, home IV magnesium, home IV antibiotic infusions. We also provide PICC (Peripherally Inserted Central Catheter) line, central line, Hickman’s line, as well as port management at home, and we also provide ventilation weaning at home, including palliative care at home.

So in today’s video, it is really sparked by a discussion that I had this week. I was actually at the Physiotherapy Conference at the Gold Coast this week, mainly ICU physiotherapists. Shout out to the Gold Coast that hosted the event, great conference!

One physiotherapist was actually coming to me and said, “Hey, look, we’ve got a patient in our ICU with Guillain–Barré syndrome, and he’s been there for 6 months. He’s a very, very slow respiratory wean. He’s not making a lot of progress. Could you wean this gentleman at home?”

Now, from my extensive experience, I have worked in critical care nursing for over 25 years in three different countries. I’ve seen a number of Guillain–Barré patients in ICU, and it is an extremely slow respiratory wean, sometimes I’ve seen 6 to 12 months in ICU. There’s no quality of life in ICU. Families have no quality of life in ICU, and one thing is for sure, the ICUs need the ICU bed. There’s no shortage of ICU patients needing the ICU bed.

So, by Intensive Care at Home taking this patient home and weaning this patient off the ventilator and the tracheostomy at home, it’s a win-win situation. ICU needs the bed, Intensive Care at Home frees it up. The cost of the ICU bed drops by about 50% from $5,000 to $6,000 per bed day in ICU in a hospital to about 50% of that. Again, it’s a win-win situation. Plus, the most important part here is that patients and families have quality of life.

Now it’s also interesting that this week, I’ve had a chat to one of our long-standing clients and they said, “Look, since we’ve been at home from ICU, our quality of life has improved big time. Most improvements have been made since we’ve been home from ICU.” Because families are in their own home and you can’t underestimate being in your own home, even when you are critically ill and need life support, which is the case for someone with Guillain–Barré syndrome on a ventilator with tracheostomy, which is the case with most of our clients.

So how can weaning off the ventilator for Guillain–Barré happen at home? Well, not dissimilar to ICU. You start with a baseline, you have a weaning plan in place. Maybe you go from a SIMV (Synchronized Intermittent Mandatory Ventilation) or an Assist Control Ventilation (ACV) mode, you wean down the respiratory rate. If a patient gets stronger, breathes up, then you wean down to a pressure support ventilation mode, and then you reduce the pressure support gradually, assuming your tidal volume stay okay, your blood gases stay okay.

I know that some of you will say, “How do you take blood gases at home?” Well, that could be done with an i-STAT machine, could also be done with some transdermal CO2 (carbon dioxide) monitoring. There’s a number of ways how to assess and manage and also succeed with weaning at home.

But I think the one of the biggest aspects here is the psychological aspect to be in your own home and not being confined to a clinical environment. ICUs are great, but once it comes to long-term patients, they’re no longer fit for purpose, I should say. I do believe that Intensive Care at Home is fit for purpose when it comes to long-term ventilation and tracheostomy in ICU. We’ve been showing that we are fit for purpose since 2012, that’s how long we’ve been operating Intensive Care at Home.

So, it’s all a matter of mindset to put the resources and strategies in place to make weaning possible at home, which includes obviously an ICU consultant, which we have as a contractor here at Intensive Care at Home. The strategies and the resources are in place. We have a highly experienced nursing team.

As a matter of fact, we are employing hundreds of years of critical care nursing experience combined in the community, that is unmatched. No other service provider in Australia can bring hundreds of years of intensive care nursing experience into the community and replicate the ICU bed in the community, ask our clients.

So, it can all be done so don’t despair or give up if you are in ICU and you are in ICU for 6 months with Guillain–Barré, confines them to ICU with ventilation, tracheostomy, sometimes it might be long term inotropes as well. All conditions that can be managed at home, there’s no doubt. We have enough case studies, built to make it happen for you as well.

So, if you are in a situation where you are stuck in ICU long-term, let us know at intensivecareathome.com and reach out to us. We will help you to get your home or your family member home step by step, including but not limited to Guillain–Barré, and included but not limited to weaning off the ventilator if it’s clinically appropriate and possible, of course.

Now, with Intensive Care at Home, we are currently sending our ICU and critical care nurses into the home, 24 hours a day. We are providing the following:

• Home care services for ventilated adults & children with tracheostomies  with critical care nurses 24 hours a day
• Genuine alternative to a long-term stay in intensive care or at long-term acute care
• Tracheostomy care for clients without ventilation
• Home care services for patients on non-invasive ventilation such as Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure)
• Home TPN (Total Parenteral Nutrition), which is also known as IV nutrition
• Home IV potassium and home IV magnesium infusions, IV fluids, and IV antibiotics
• Providing central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as port management at home.
• Providing nasogastric tube  and PEG (Percutaneous Endoscopic Gastrostomy) tube management at home
• Use cough assist machines for our clients for airway clearance at home
• Palliative care services at home
• Ventilator weaning at home

We’re also sending our critical care nurses into the home for emergency department bypass services. We have done so successfully as part of the Western Sydney Local Area Health District, their in-touch program, saving approximately $2,000 per patient that we keep at home, instead of them going to an emergency department.

That also means, we’re also in a position to cut the cost of an intensive care bed by around 50%. An intensive care bed costs between $5,000 to $6,000 per bed day. Our services costs between $2,500 to $3,000 per bed day, and we’re freeing up the most sought-after bed in the hospital, which is the ICU bed. Most importantly, we’re improving the quality of life for patients and their families, which is a win-win situation for all stakeholders. Of course, quality of life is much improved surrounded by families and by a team of dedicated intensive care nurses in the home care setting instead of in an intensive care unit.

With Intensive Care at Home, we are currently operating all around Australia in all major capital cities as well as in all regional and rural areas. We work with NDIS (National Disability Insurance Scheme) clients all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria, Department of Veteran Affairs (DVA) all around Australia. Our clients and we, as a service provider, have also received funding through public hospitals, private health funds, as well as Departments of Health.

We are having policies and procedures for Intensive Care at Home nursing and we’ve built all the intellectual property for Intensive Care at Home since 2012. No other provider in Australia has created more intellectual property when it comes to Intensive Care at Home nursing than we have. This puts us in a position to employ hundreds of years of critical care nursing experience combined in the community. No other service provider in 2025 employs a higher skill level in the community than we do, which enables us to look after the highest acuity adults and children in the community in Australia safely.

If you’re at home already and you’re watching this, or you’re stuck in an ICU long-term, or if you’re going to the hospital and ED all the time, and you realize that you don’t have the right level of support at home, or if you are stuck in an ICU, I’ll give you a real-world example today, how we can help you.

One of our first clients when we first got started in 2012 was a client who was at home initially on a ventilator with a tracheostomy with a support worker model 24/7. Of course, support workers are not equipped to look after a client at home on a ventilator with a tracheostomy. That is dangerous and it’s simply negligent. Having support workers looking after a client at home on a ventilator with a tracheostomy is like flying the airplane with a cabin crew instead of the pilot. Because anyone on a ventilator with a tracheostomy is at very high risk of medical emergencies 24/7, or even at high risk of dying if they don’t have a team of dedicated critical care nurses looking after them 24/7 at home. This is actually evidence-based and is documented in our Mechanical Home Ventilation Guidelines that you can find on our website at intensivecareathome.com.

Think about it, in an intensive care unit in a hospital, you wouldn’t have support workers looking after your critically ill loved one or after any critically ill patient on a ventilator with a tracheostomy. So, why would anyone in their right mind do that in the home care environment in the community?

So, this client at the time found out about us eventually, and the ICU that he was basically living in also knew about us and eventually reached out to us. We were proving our concept with this client very fast. When we worked with this particular client, we sent him critical care nurses, 24 hours a day. He never ever went back into ICU ever again, as long as we were working with this client.

We can do the same for you if you’re not safe at home and help you with keeping you at home predictably. Otherwise, we would not be in business. Again, the same is applicable for those stuck in an ICU, similar to this case study that I’ve just given you, or if you’re going back to ED all the time, please reach out to us. We can help you with taking you through the right steps, including how to get funding with different funding bodies.

This is also why we are providing NDIS Support Coordination. We have a team of NDIS Support Coordinators, and they have a wealth of knowledge. I’ve done an interview with Amanda Riches (one of our NDIS support coordinators, and I’ll put a link to an interview with Amanda in the written version of this blog. We’re also providing TAC case management and WorkSafe case management in Victoria with Lucy McCotter.

If you’re an NDIS support coordinator or a case manager from another organization watching this, and you’re looking for nursing care for your participants, please reach out to us as well. If you need more evidence for nursing care, we are also writing NDIS nursing assessments with legal nurse critical care consulting nurses.

If you are a critical care nurse and you’re looking for a career change and you want to join a very progressive, dynamic, and high performing team of critical care nurses in the community, we’re employing hundreds of years of critical care nursing experience combined. You can join this high performing team if you are a critical care nurse.

If you are looking for a career change as a critical care nurse, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, in Albury, Wodonga, in Bendigo, in Geelong, in Warragul in Victoria. If you have worked in critical care nursing for a minimum of 2 years pediatric ICU, ED, and you have already completed a postgraduate critical care nursing qualification, we will be delighted hearing from you.

I do have a disclaimer though, because we are offering a tailor-made solution for our clients, which includes regular staff, our clients also do want the same staff coming over and over again because they are so vulnerable and so special. That’s why we need regular staff. So, if you’re looking for agency work, where you can come and go, this will not be the right fit for you. We are looking for consistency and our clients are looking for consistency. So please, only apply with us if you can give us regular and consistent availabilities for shifts, and you’re really keen on building solid relationships with us and with our clients.

If you’re an intensive care specialist or an ED specialist, we also want to hear from you. We’re currently expanding our medical team as well. We can also help you eliminate your bed blocks in your ICU and in your ED for your long-term patients, or for your regularly readmitting patients with our critical care nursing team at home. We’re here to help you take the pressure off your ICU and ED beds. In most cases, you won’t even pay for it. Even if you do pay for it, it is so much more cost-effective than what you’re paying for in ICU and ED, and you get the same level of care.

If you’re a hospital executive watching this and you have bed blocks in your ICU, ED, and respiratory wards, or for home TPN, please reach out to us as well. We can help you eliminate your bed blocks very fast.

If you’re in the U.S. and in the U.K. and you’re watching this, and you need help, we want to hear from you as well. We can help you there privately with one-on-one consulting and with hiring nurses privately.

Once again, our website is intensivecareathome.com. Call us on one of the numbers on the top of our website, or simply send us an email to [email protected].

If you like my videos, subscribe to my YouTube channel for regular updates for families with Intensive Care at Home and intensive care. Click the like button, click the notification bell, share this video with your friends and families, and comment below what you want to see next or what questions and insights you have from this video.

Thank you so much for watching.

This is Patrik Hutzel from intensivecareathome.com and I will talk to you in a few days.

Take care for now.