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Home mechanical ventilation in children: Retrospective survey of a pediatric population

2007; Wiley; Volume: 49; Issue: 6 Linguagem: Inglês

10.1111/j.1442-200x.2007.02463.x

1442-200X

G. Ottonello, Ilaria Ferrari, INES MARIA GRAZIA PIRRODDI, Maria Cristina Diana, G. Villa, L H Nahum, Pietro Tuo, Andrea Moscatelli, Gilberto Silvestri,

Neuroscience of respiration and sleep

Home care support is beneficial for children needing mechanical ventilation, when clinically stable.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.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.Although home care ventilation is not yet widely diffused, it represents a valid alternative to long hospitalization for children with stable chronic respiratory failure.