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Characteristics and outcomes in children on long-term mechanical ventilation: the experience of a pediatric tertiary center in Rome
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Characteristics and outcomes in children on long-term mechanical ventilation: the experience of a pediatric tertiary center in Rome
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Characteristics and outcomes in children on long-term mechanical ventilation: the experience of a pediatric tertiary center in Rome
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Journal Article
Characteristics and outcomes in children on long-term mechanical ventilation: the experience of a pediatric tertiary center in Rome
2020
Overview
Background
Children with chronic respiratory failure and/or sleep disordered breathing due to a broad range of diseases may require long-term ventilation to be managed at home. Advances in the use of long-term non-invasive ventilation has progressively leaded to a reduction of the need for invasive mechanical ventilation through tracheostomy. In this study, we sought to characterize a cohort of children using long-term NIV and IMV and to perform an analysis of those children who showed significant changes in ventilatory support management.
Methods
We performed a retrospective cohort study of pediatric (within 18 years old) patients using long-term, NIV and IMV, hospitalized in our center between January 1, 2000 and December 31, 2017. A total of 432 children were included in the study. Long Term Ventilation (LTV) was defined as IMV or NIV, performed on a daily basis, at least 6 h/day, for a period of at least 3 months.
Results
315 (72.9%) received non-invasive ventilation (NIV); 117 (27.1%) received invasive mechanical ventilation (IMV). Children suffered mainly from neuromuscular (30.6%), upper airway (24.8%) and central nervous system diseases (22.7%). Children on IMV were significantly younger when they start LTV [NIV: 6.4 (1.2–12.8) years vs IMV 2.1 (0.8–7.8) years] (
p
< 0.001)]. IMV was likely associated with younger age at starting ventilatory support (aOR 0.9428;
p
= 0.0220), and being a child with home health care (aOR 11.4;
p
< 0.0001). Overtime 39 children improved (9%), 11 children on NIV (3.5%) received tracheostomy; 62 children died (14.3%); and 74 children (17.1%) were lost to follow-up (17.8% on NIV, 15.4% on IMV).
Conclusions
Children on LTV suffered mainly from neuromuscular, upper airways, and central nervous system diseases. Children invasively ventilated usually started support younger and were more severely ills.
Publisher
BioMed Central,Springer Nature B.V,BMC
Subject
