Safety of Hospitalized Ventilator-dependent Children Outside of the Intensive Care Unit

Ambrosio, I. U.; Woo, Marlyn S.; Jansen, Mary T.; Keens, Thomas G.

doi:10.1542/peds.101.2.257

Cited by 31 publications

(5 citation statements)

References 14 publications

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“…This demand will continue to become more difficult to accommodate. Therefore, if this population continues to grow at a similar rate, the development of step‐down units or other specialized facilities outside of the ICU will likely be needed to accommodate this population …”

Section: Discussionmentioning

confidence: 99%

Pediatric long-term home mechanical ventilation: Twenty years of follow-up from one Canadian center

et al. 2013

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In summary, our 20-year retrospective study has shown that there has been an exponential growth in the number of children receiving domiciliary LTMV with the majority of children having favorable outcomes. Our study represents a step towards developing a Canadian registry to design and implement programmatic change for this medically complex population to ensure best practice for these children as well as their families.

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Section: Discussionmentioning

confidence: 99%

Pediatric long-term home mechanical ventilation: Twenty years of follow-up from one Canadian center

et al. 2013

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“…In the United States of America ‘ventilator‐dependent’ children have been cared for in less acute hospital settings prior to discharge ( Prentice, 1986; Dixon & Holmes, 1987; O’Donohue et al ., 1988 ; Nochomovitz et al ., 1991 ; Ambrosio et al ., 1998 ). Foster care has also been initiated in children whose parents are not able to care for them ( Yost et al ., 1988 ).…”

Section: Resultsmentioning

confidence: 99%

‘Ventilator‐dependent’ children who spend prolonged periods of time in intensive care units when they no longer have a medical need or want to be there

Noyes

2000

Journal of Clinical Nursing

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• Children who are dependent on ventilators currently spend many months and in some cases years in intensive care units when they no longer have a medical need to be there. • This article presents the views of 18 young ‘ventilator‐dependent’ people (and their parents) who experienced prolonged periods of time in intensive care units and compares their experiences with published literature. • Findings strongly suggest that living in an intensive care unit is inappropriate and detrimental to health and well‐being. • Recommendations are made regarding the need for alternative placements, appropriate nursing care, the review of funding and discharge management procedures, and upholding children’s rights.

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“…Such units are referred to as “BPD units”, “step‐down ICUs”, “progressive care units”, or “transitional care units.” Other programs have highly‐trained nurses and respiratory therapists on the inpatient pulmonary floor with expertise to care for infants and children with tracheostomies and home ventilators. This approach of transitioning out of the NICU has been demonstrated to be safe, 41 cost effective, 42 and supports a change in the focus of care from the management of critical illness to care coordination and preparing the child and family for discharge to home through educating family caregivers, ordering durable medical equipment, and recruiting home nursing 43 …”

Section: Transition From the Intensive Care Unit (Icu) Ventilator To A Home Ventilatormentioning

confidence: 88%

Chronic respiratory failure in bronchopulmonary dysplasia

Baker

2021

Pediatric Pulmonology

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Although survival has improved dramatically for extremely preterm infants, those with the most severe forms of bronchopulmonary dysplasia (BPD) fail to improve in the neonatal period and go on to develop chronic respiratory failure. When careful weaning of respiratory support is not tolerated, the difficult decision of whether or not to pursue chronic ventilation via tracheostomy must be made. This requires shared decision‐making with an interdisciplinary medical team and the child's family. Although they suffer from increased morbidity and mortality, the majority of these children will survive to tolerate ventilator liberation and tracheostomy decannulation. Care coordination for the technology‐dependent preterm infant is complex, but there is a growing consensus that chronic ventilation can best support neurodevelopmental progress and improve long‐term outcomes.

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Safety of Hospitalized Ventilator-dependent Children Outside of the Intensive Care Unit

Cited by 31 publications

References 14 publications

Pediatric long-term home mechanical ventilation: Twenty years of follow-up from one Canadian center

Pediatric long-term home mechanical ventilation: Twenty years of follow-up from one Canadian center

‘Ventilator‐dependent’ children who spend prolonged periods of time in intensive care units when they no longer have a medical need or want to be there

Chronic respiratory failure in bronchopulmonary dysplasia

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