Inpatient Health Care Utilization for Children Dependent on Long-term Mechanical Ventilation

Benneyworth, Brian D.; Gebremariam, Achamyeleh; Clark, Sarah J.; Shanley, Thomas P.; Davis, Matthew M.

doi:10.1542/peds.2010-2026

Cited by 98 publications

(97 citation statements)

References 25 publications

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“…35,36 Although no other studies have addressed the rehospitalization rates for children with tracheostomy, before and after decannulation, several have found that children who are ventilator dependent at home have a higher risk of rehospitalization than other children. 11,12,[36][37][38][39] The decrease in readmission rate after decannulation may be secondary to removal of the tracheostomy, improvement in BPD, or both.…”

Section: Discussionmentioning

confidence: 99%

“…11 In addition, the rate of hospital discharges for all children dependent on long-term mechanical ventilation increased 55% from 2000 to 2006. 12 The respiratory outcomes of patients with BPD range from no oxygen requirement to chronic ventilator dependency. Various publications [13][14][15] address the outcome of the least severe types of BPD, yet very limited data exist on BPDrelated chronic respiratory failure.…”

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confidence: 99%

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Outcomes of Children With Severe Bronchopulmonary Dysplasia Who Were Ventilator Dependent at Home

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Respiratory outcomes of patients with bronchopulmonary dysplasia (BPD) range from no oxygen requirement to chronic respiratory failure. Outcomes of least severe types of BPD are well described. Limited data exist on outcomes of patients with BPD-related chronic ventilator dependency. WHAT THIS STUDY ADDS:Along with a first estimation of the incidence of patients with severe BPD-related chronic respiratory failure who were dependent on positive pressure ventilation via tracheostomy at home, we describe their survival rate, liberation from positive pressure ventilation, and decannulation. abstract OBJECTIVE: To describe the incidence and outcomes of children with chronic respiratory failure secondary to severe bronchopulmonary dysplasia (BPD) on chronic positive pressure ventilation (PPV) via tracheostomy at home. METHODS:We retrospectively reviewed medical charts of patients with severe BPD who were PPV dependent at home and who were enrolled in a university-affiliated home ventilator program between 1984 and 2010. We excluded patients with other comorbidities that could contribute to the development of chronic respiratory failure. We reported the incidence of these children in Indiana and cumulative incidences of survival, liberation from PPV, and decannulation.RESULTS: Over 27 years, 628 children were cared for in our home ventilator program. Of these, 102 patients met inclusion criteria: 83 (81.4%) were alive and 19 (18.6%) were deceased. Sixty-nine patients (67.6%) were liberated from PPV, and 97.1% of them were weaned before their fifth birthday, with a median age at liberation of 24 months (interquartile range, 19-33). Similarly, 60 patients (58.8%) were decannulated, of which 96.7% completed this process before their sixth birthday, with a median age at decannulation of 37.5 months (interquartile range, 31.5-45). The incidence of children with chronic respiratory failure secondary to BPD who were PPVdependent at home in Indiana was 1.23 per 100 000 live births in 1984 and increased to 4.77 per 100 000 live births in 2010.CONCLUSIONS: Although extreme prematurity associated with severe BPD necessitating PPV at home carries significant risks of morbidity and mortality, successful liberation from mechanical ventilation and decannulation are likely to occur. Pediatrics 2013;132:e727-e734

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Outcomes of Children With Severe Bronchopulmonary Dysplasia Who Were Ventilator Dependent at Home

et al. 2013

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“…This definition of operative mortality is particularly relevant to our study population, since patients with tracheostomy after cardiac surgery often are transferred for ongoing care to either secondary acute care or rehabilitation facilities. [6,11]. We Table 1, and the 10 most common primary cardiac diagnoses and index cardiac surgical procedures performed are listed in Table 2.…”

Section: Data Collection and Definitionsmentioning

confidence: 99%

Tracheostomy After Operations for Congenital Heart Disease: An Analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database

Mastropietro

Benneyworth

Turrentine

et al. 2016

The Annals of Thoracic Surgery

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“…Benneyworth et al 15 estimated the prevalence to be 6 -14 per 100,000 children. In terms of in-patient admissions, the rate is estimated to be 174 per 100,000 non-newborn pediatric discharges.…”

Section: Trends and Outcomesmentioning

confidence: 99%

The Chronically Critically Ill Patient: Pediatric Considerations

Peterson‐Carmichael¹,

Cheifetz²

2012

Respir Care

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Whether defined as chronically critically ill, long-term mechanical ventilator dependent (or otherwise chronically medically supported), or medically fragile, a population of infants and children with chronic illness clearly exists. Infants and children with chronic healthcare needs are at an increased risk for physical, developmental, behavioral, and/or emotional conditions and generally require healthcare services of a type or amount beyond that of a general pediatric or adult population. This review will focus on the specific management and psychosocial needs associated with the healthcare of this subgroup of infants and children with chronic illness. Attention will be paid to defining the population, describing trends over time, reviewing their special needs, and discussing outcomes. Increased focus and an increasing quantity of resources for this subgroup of infants and children are needed, as the number of such pediatric patients continues to grow.

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Inpatient Health Care Utilization for Children Dependent on Long-term Mechanical Ventilation

Cited by 98 publications

References 25 publications

Outcomes of Children With Severe Bronchopulmonary Dysplasia Who Were Ventilator Dependent at Home

Outcomes of Children With Severe Bronchopulmonary Dysplasia Who Were Ventilator Dependent at Home

Tracheostomy After Operations for Congenital Heart Disease: An Analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database

The Chronically Critically Ill Patient: Pediatric Considerations

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