Risk factors for morbidity and mortality in pediatric home mechanical ventilation

Clin Pediatr (Phila). 2011 Mar;50(3):237-43. doi: 10.1177/0009922810388508. Epub 2010 Dec 2.

Abstract

Background: Home mechanical ventilation (HMV) is increasingly used in children with chronic respiratory insufficiency, but data on incidence and type of adverse events are limited.

Setting: Pediatric HMV program at a tertiary university hospital.

Methods: The authors retrospectively analyzed the type and incidence of severe emergencies in a mixed pediatric HMV program.

Results: In all, 295 patient-years of HMV in 54 patients could be analyzed. A total of 26 patients had neuromuscular disease. In 16 patients, mechanical ventilation was initiated at <1 year of age. A total of 45 children were ventilated via tracheostomy and 9 by nasal mask. This study identified 68 severe emergencies (0.2 per patient-year) leading to 4 deaths. Respiratory causes were found in 48 cases (including 15 tracheostomy-related and 3 ventilator failures). Only age, but not underlying diagnosis or mode of ventilation, correlated with incidence of emergencies.

Conclusions: Pediatric HMV including all age and diagnostic groups shows a low incidence of emergencies.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Child
  • Child, Preschool
  • Chronic Disease
  • Emergencies
  • Female
  • Home Care Services*
  • Humans
  • Male
  • Masks / adverse effects
  • Morbidity
  • Respiration, Artificial / adverse effects*
  • Respiration, Artificial / mortality
  • Respiratory Insufficiency / therapy*
  • Retrospective Studies
  • Risk Factors
  • Tracheostomy / adverse effects
  • Young Adult