Long-term ventilation in children: longitudinal trends and outcomes

McDougall, Catherine; Adderley, Robert J.; Wensley, David; Seear, Michael

doi:10.1136/archdischild-2012-303062

Cited by 129 publications

(170 citation statements)

References 21 publications

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“…9 Several single-center studies conducted in Canada reported a rising prevalence of ventilator-assisted children. 10,11 Although a report from the Provincial Respiratory Outreach Program in British Columbia 12 indicated the prevalence to be 9.5/100,000 adults in a single province, no comprehensive national data describe prevalence of such individuals.…”

Section: Introductionmentioning

confidence: 99%

Home Mechanical Ventilation in Canada: A National Survey

et al. 2015

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. RESULTS: The survey response rate was 152/171 (89%). We identified 4,334 ventilator-assisted individuals: an estimated prevalence of 12.9/100,000 population, with 73% receiving noninvasive ventilation (NIV) and 18% receiving intermittent mandatory ventilation (9% not reported). Services were delivered by 39 institutional providers and 113 community providers. We identified variation in initiation criteria for NIV, with polysomnography demonstrating nocturnal hypoventilation (57%), daytime hypercapnia (38%), and nocturnal hypercapnia (32%) as the most common criteria. Various models of ventilator servicing were reported. Most providers (64%) stated that caregiver competency was a prerequisite for home discharge; however, repeated competency assessment and retraining were offered by only 45%. Important barriers to home transition were: insufficient funding for paid caregivers, equipment, and supplies; a shortage of paid caregivers; and negotiating public funding arrangements. CONCLUSIONS: Ventilatory support in the community appears well-established, with most individuals managed with NIV. Although caregiver competency is a prerequisite to discharge, ongoing assessment and retraining were infrequent. Funding and caregiver availability were important barriers to home transition.

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Section: Introductionmentioning

confidence: 99%

Home Mechanical Ventilation in Canada: A National Survey

et al. 2015

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“…This has given rise to a new pediatric population represented by young patients on LTMV-H, be it invasive (IMV) or non-invasive (NIV), that has been growing more rapidly in the last few years, especially the latter subgroup [4,13].…”

Section: Introductionmentioning

confidence: 99%

“…In many countries the last two decades have seen a gradual increase in the prevalence of pediatric patients on long-term mechanical ventilation at home (LTMV-H) [1][2][3][4][5][6][7][8][9][10][11][12] as a result of advances in medicine and technology affording these children a longer survival [1][2][3][4][7][8][9]11,12]. This has given rise to a new pediatric population represented by young patients on LTMV-H, be it invasive (IMV) or non-invasive (NIV), that has been growing more rapidly in the last few years, especially the latter subgroup [4,13].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Ventilation at Home and Pediatric Palliative Care: Patients’ Characterization in an Italian Regional Survey

Rusalen¹,

Agosto²,

Brugnaro³

et al. 2015

J Palliat Care Med

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Background: The prevalence of children receiving long-term mechanical ventilation at home (LTMV-H) is rising in many countries as advances in technology and medicine extend the survival of such patients. In Italy, the prevalence is 4.2 per 100,000 pediatric patients. It becomes essential to thoroughly assess these patients' needs, and of the quality and adequacy of their home care. Pediatric palliative care (PPC) may be an appropriate strategy for the global care and quality of life of children needing LTMV-H and their families.

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“…And this will become an ever increasing important medical care issue as advances in NIV technology and application have allowed more pediatric and adult patients with underlying nocturnal hypoventilation secondary to obesity or NMD the potential for long-term home NIV care outside of a hospital or skilled nursing facility. 4,5 …”

mentioning

confidence: 99%

“…We know that there is signifi cant morbidity and mortality in patients with underlying nocturnal hypoventilation secondary to obesity or NMD left untreated, 2 and there is longitudinal evidence showing improvement in quality of life and morbidity and mortality in youth when NIV initiation is successful. [3][4][5][6] However there are many barriers which must be overcome for successful initiation and use of NIV long-term home care. 7,8 It is important to pinpoint and overcome barriers to initiation of NIV in both youths and adults, as an early pattern of adherence to CPAP therapy is a signifi cant predictor of subsequent adherence.…”

mentioning

confidence: 99%