OBJECTIVE: Home ventilatory support systems are a treatment option for patients with severe chronic respiratory failure. The objective of the present study was to characterize the children admitted to a home ventilatory assistance program. PATIENTS AND METHOD: The home ventilation program was created by our hospital to coordinate professional and technological support for chronic ventilator-dependent children. We revised and updated information on patient characteristics, type of assisted ventilation, respiratory morbidity, and equipment failures between 1993 and 2004. RESULTS: Follow-up of 35 children (18 male) was carried out by our hospital staff. Median age upon admission to the program was 12 months (range, 5 months to 14 years). Median length of time in the program was 21 months and we were able to wean 40% of patients from ventilators. Six patients died. The main indications for assisted ventilation were neuromuscular disease (12 cases), airway abnormality (11 cases), cardiopulmonary disease (7 cases), and hypoventilation syndrome (5 cases). The types of assisted ventilation used were continuous positive airway pressure (in 17 cases), bilevel positive pressure (in 8 cases), and synchronized intermittent mandatory ventilation (in 10 cases). Invasive ventilation via a tracheostomy was used in 26 cases. The use of noninvasive ventilation increased in the last 4 years. Respiratory morbidity (pneumonia and bacterial tracheitis) was the most frequent cause of hospitalization and the annual rate of such episodes was 1.6 per child. The annual rate of hospitalization due to equipment failures was 0.1 per child. CONCLUSION: The program provides safe and necessary home ventilatory assistance for children with severe chronic respiratory failure. The professional support that home hospitalization offers had a positive effect on outcome in these children. It is important to take our experience into account in creating a Chilean national home ventilatory assistance program.
OBJECTIVE: Home ventilatory support systems are a treatment option for patients with severe chronic respiratory failure. The objective of the present study was to characterize the children admitted to a home ventilatory assistance program. PATIENTS AND METHOD: The home ventilation program was created by our hospital to coordinate professional and technological support for chronic ventilator-dependent children. We revised and updated information on patient characteristics, type of assisted ventilation, respiratory morbidity, and equipment failures between 1993 and 2004. RESULTS: Follow-up of 35 children (18 male) was carried out by our hospital staff. Median age upon admission to the program was 12 months (range, 5 months to 14 years). Median length of time in the program was 21 months and we were able to wean 40% of patients from ventilators. Six patients died. The main indications for assisted ventilation were neuromuscular disease (12 cases), airway abnormality (11 cases), cardiopulmonary disease (7 cases), and hypoventilation syndrome (5 cases). The types of assisted ventilation used were continuous positive airway pressure (in 17 cases), bilevel positive pressure (in 8 cases), and synchronized intermittent mandatory ventilation (in 10 cases). Invasive ventilation via a tracheostomy was used in 26 cases. The use of noninvasive ventilation increased in the last 4 years. Respiratory morbidity (pneumonia and bacterial tracheitis) was the most frequent cause of hospitalization and the annual rate of such episodes was 1.6 per child. The annual rate of hospitalization due to equipment failures was 0.1 per child. CONCLUSION: The program provides safe and necessary home ventilatory assistance for children with severe chronic respiratory failure. The professional support that home hospitalization offers had a positive effect on outcome in these children. It is important to take our experience into account in creating a Chilean national home ventilatory assistance program.
Authors: Rafael González; Amaya Bustinza; Sarah N Fernandez; Miriam García; Silvia Rodriguez; Ma Ángeles García-Teresa; Mirella Gaboli; Silvia García; Olaia Sardón; Diego García; Antonio Salcedo; Antonio Rodríguez; Ma Carmen Luna; Arturo Hernández; Catalina González; Alberto Medina; Estela Pérez; Alicia Callejón; Juan D Toledo; Mercedes Herranz; Jesús López-Herce Journal: Eur J Pediatr Date: 2017-08-12 Impact factor: 3.183
Authors: Prabhjot K Bedi; Maria Luisa Castro-Codesal; Robin Featherstone; Mohammed M AlBalawi; Bashar Alkhaledi; Anita L Kozyrskyj; Carlos Flores-Mir; Joanna E MacLean Journal: Front Pediatr Date: 2018-02-12 Impact factor: 3.418
Authors: Mireu Park; Haerin Jang; In Suk Sol; Soo Yeon Kim; Young Suh Kim; Yoon Hee Kim; Myung Hyun Sohn; Kyung Won Kim Journal: J Korean Med Sci Date: 2019-11-04 Impact factor: 2.153