Indications and practice of home invasive mechanical ventilation in children

Abstract

BackgroundDevelopments and technological advances in neonatal and pediatric intensive care units have led to a prolonged life expectancy of pediatric patients with chronic respiratory failure. Therefore, the number of hemodynamically stable pediatric patients with chronic respiratory failure who need mechanical ventilator assistance throughout the day has significantly increased.AimsNumerous conditions, including parenchymal lung diseases, airway disorders, neuromotor disorders, or respiratory defects, can lead to chronic respiratory failure. For individuals who cannot tolerate non‐invasive mechanical ventilation (NIMV), invasive mechanical ventilation (IMV) is the only suitable choice. Due to increasing need, mechanical ventilator technology is continuously evolving.ResultsAs a result of this process, home‐type mechanical ventilators have been produced for patients requiring long‐term IMV. Patients with chronic respiratory failure can be safely monitored at home with these ventilators.DiscussionHome follow‐up of these patients has many benefits such as an increase in general quality of life and a positive contribution to their emotional and cognitive development.ConclusionIn this compilation, indications for home‐based IMV, features of home invasive mechanical ventilators (HMVs), patient monitoring, and the detailed advantages of using IMV at home will be elucidated.

Multidisciplinary management of pediatric patients on home invasive mechanical ventilation

“…Selecting which children and families will benefit from HIMV is important and requires meticulous preparation to ensure feasibility and safety in the home setting. In this special issue, Bayav et al 1 discuss indications for HIMV and describe patient monitoring, and benefits of offering HIMV; Henningfeld et al 2 outline essential factors in determining discharge from hospital readiness such as medical stability, caregiver competence, and home environment suitability; Zirek et al 3 emphasize the critical role of caregiver education regarding the knowledge and skills they must acquire to use the equipment confidently and safely; Torrent-Vernetta et al 4 discuss how the home environment should be modified before hospital discharge and other essential equipment needs.…”