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Home mechanical ventilation in children: Retrospective survey of a pediatric population
Author(s) -
OTTONELLO GIANCARLO,
FERRARI ILARIA,
PIRRODDI INES MARIA GRAZIA,
DIANA MARIA CRISTINA,
VILLA GIOVANNA,
NAHUM LAURA,
TUO PIETRO,
MOSCATELLI ANDREA,
SILVESTRI GILBERTO
Publication year - 2007
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.2007.02463.x
Subject(s) - medicine , mechanical ventilation , hypoventilation , congenital central hypoventilation syndrome , pediatrics , respiratory failure , ventilation (architecture) , retrospective cohort study , population , diaphragmatic breathing , respiratory system , surgery , anesthesia , mechanical engineering , alternative medicine , environmental health , pathology , engineering
Background: Home care support is beneficial for children needing mechanical ventilation, when clinically stable. Methods: A retrospective analysis was carried out of the long‐term home ventilation management of a pediatric population with chronic respiratory failure composed of 20 ventilator‐dependent children categorized according to age, diagnosis and ventilation support. Age groups consisted of 10% under 1 year, 30% between 2 and 5 years, 30% between 6 and 12 years, and 30% older than 12 years. Diagnostic categories included myopathic disorder, n = 5; congenital central hypoventilation syndrome, n = 6; chest wall disorder, n = 5; cystic fibrosis, n = 1; pulmonary hypertension, n = 1; and diaphragmatic paralysis, n = 2. Results: Sixty‐five percent were ventilated using non‐invasive mode (NIMV): eight with nasal mask, five with full‐face mask, and two children in NIMV also used negative pressure mode; 35% were ventilated using tracheostomy, one of them also used a diaphragmatic pacer. Seventy percent needed nocturnal ventilatory support, (20% 12–18 h, 10% full‐day). A total of 18 children were included in the home care and follow‐up program. Two children died: one because of worsening of his chronic disease and one because of septic shock. Conclusion: Although home care ventilation is not yet widely diffused, it represents a valid alternative to long hospitalization for children with stable chronic respiratory failure.