No abstract

The number of children requiring long-term ventilation support is increasing in many countries around the world. Children benefit from being mechanically ventilated at home rather than staying in the hospital for a longer period of time. Here, we have reviewed the related literatures and guidelines on pediatric home mechanical ventilation and shared our experience in Thailand, where there is no federal or insurance coverage for home care. An economic approach has been taken that includes using less expensive ventilators, training non-professional family caregivers, and seeking funding resources. We also report on the favorable outcome of a program we started in 1995. Of 148 children, 95 (64.2 %) have used noninvasive ventilators, 128 (86.5 %) survive, 20 (13.5 %) were weaned off, only four (2.7 %) died unexpectedly. We hope that this model approach may be useful in some areas with similar difficulties. Keywords Chronic respiratory failure Á Respiratory insufficiency Á Home mechanical ventilation Á Long-term mechanical ventilator Á BPAP Á CPAP

The pediatric resuscitation course should still remain in the pediatric resident curriculum and should be re-evaluated frequently. Video-recorded feedback on the pitfalls during individual CPR skills and mock code case scenarios could improve short-term psychomotor CPR skills and lead to higher quality CPR performance.

The difference between maximal and minimal QT interval and corrected QT interval defined as QT dispersion and corrected QT dispersion may represent arrhythmogenic risks. This study sought to evaluate QT dispersion and corrected QT dispersion in childhood obstructive sleep apnoea syndrome. Forty-four children (34 male) with obstructive sleep apnoea syndrome, aged 6.2 plus or minus 3.5 years along with 38 healthy children (25 male), 6.6 plus or minus 2.1 years underwent electrocardiography to measure QT and RR intervals. Means QT dispersion and corrected QT dispersion were significantly higher in obstructive sleep apnoea syndrome than controls, 52 plus or minus 27 compared to 40 plus or minus 14 milliseconds (p equal to 0.014), and 71 plus or minus 29 compared to 57 plus or minus 19 milliseconds (p equal to 0.010), respectively. Interestingly, QT dispersion and corrected QT dispersion in obstructive sleep apnoea syndrome with obesity, 57 plus or minus 30 and 73 plus or minus 31 milliseconds, were significantly higher than in control, 40 plus or minus 14 and 57 plus or minus 19 milliseconds (p equal to 0.009 and 0.043, respectively). However, QT dispersion and corrected QT dispersion in obstructive sleep apnoea syndrome without obesity, 43 plus or minus 20 and 68 plus or minus 26 milliseconds, were not significantly different. In conclusion, QT dispersion and corrected QT dispersion were significantly increased only in childhood obstructive sleep apnoea syndrome with obesity. Obesity may be the factor affecting the increased QT dispersion and corrected QT dispersion.