Long-term ventilation in children: Ten years later

AbstractIntroductionHome mechanical ventilation (HMV) represents a treatment option for patients with chronic respiratory failure and has changed prognosis and survival of many disorders in children. The aim of this study was to characterize a group of children on long-term mechanical ventilation (L...

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Published in:Revista portuguesa de pneumologia (English ed.) 2015-01, Vol.21 (1), p.16-21
Main Authors: Cancelinha, C, Madureira, N, Mação, P, Pleno, P, Silva, T, Estêvão, M.H, Félix, M
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Chronic Disease
Female
Follow-Up Studies
Home
Humans
Infant
Infant, Newborn
Internal Medicine
Long-term mechanical ventilation
Male
Pulmonary/Respiratory
Respiration, Artificial
Respiratory Insufficiency - therapy
Retrospective Studies
Ten years
Time Factors
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Summary:AbstractIntroductionHome mechanical ventilation (HMV) represents a treatment option for patients with chronic respiratory failure and has changed prognosis and survival of many disorders in children. The aim of this study was to characterize a group of children on long-term mechanical ventilation (LTMV) for a period longer than 10 years.MethodsA retrospective analysis was carried out including patients on LTMV for more than 10 years (LTMV-10) in a tertiary pediatric hospital. Statistical analysis: PASW Statistics 18 ®. ResultsThirty-one children (61% female) belong to the LTMV-10 group. Median age at the beginning of ventilatory support was 3 years (birth to 13 years). Main indications for assisted ventilation were neuromuscular disease ( n= 12, 39%), metabolic disease ( n= 7, 23%) and central hypoventilation ( n= 6, 19%). Volume ventilation was used in 2 children, and positive pressure ventilation in the others, mainly bilevel positive airway pressure ( n= 25, 81%). Invasive ventilation via tracheostomy was used since the beginning in four cases, and subsequently in two other children. The mean time of ventilatory support was 146 months and the maximum was 219 months. Respiratory morbidity was the most frequent cause of hospitalization and the annual rate of such episodes was 0.17 per child. Global mortality rate was 19%. ConclusionsHMV programs provide necessary and safe assistance for children with severe chronic respiratory failure. As shown in our series, it is possible to be kept on this respiratory support modality for long periods with good compliance and a small number of hospitalizations.
ISSN:2173-5115
2173-5115
DOI:10.1016/j.rppnen.2014.03.017