Home Ventilation for Children with Chronic Respiratory Failure in IstanbulOktem S.a · Ersu R.a · Uyan Z.S.a · Cakir E.a · Karakoc F.a · Karadag B.a · Kiyan G.b · Dagli E.a
aDivision of Pediatric Pulmonology and bDepartment of Pediatric Surgery, Marmara University, Istanbul, Turkey
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Article / Publication Details
Background: The number of children on home mechanical ventilation (HMV) has increased markedly in Europe and North America but little is known about the HMV use and outcomes in children in Turkey. Objective: To review clinical conditions and outcome of children who were discharged from the hospital on respiratory support. Methods: Thirty-four patients assessed at the Marmara University Hospital in Istanbul who had been receiving ventilatory support at home for more than 3 months were included in the study. Results: Thirty-four patients with a median age of 5.1 years were discharged home with ventilatory support. HMV was started in 2001 at our institution and the number of children treated has increased substantially since then (2001: n = 1, 2002: n = 3, 2003: n = 3, 2004: n = 2, 2005: n = 14, 2006: n = 11).Ventilatory support was started at a median age of 1.8 years and continued for 13 months. Eleven (32.4%) patients received invasive mechanical ventilation via tracheostomy and 23 (67.6%) patients received noninvasive mechanical ventilation. Sixteen children (47.1%) were on noninvasive mechanical ventilation via nasal mask while 7 (20.6%) used a face mask. Seven (20.6%) patients received ventilatory support for 24 h and 27 (79.4%) patients were supported only during sleep. Twenty-four (70.6%) children received supplemental oxygen in addition to ventilatory support. Three patients successfully came off ventilatory support; 11 patients died during follow-up. None of the patients had home nursing and there were no life-threatening complications. Conclusions: A rapidly rising trend of HMV use in chronic respiratory failure (CRF) has been observed in this study. HMV can be safely applied in selected children with CRF with close monitoring and proper follow-up in developing countries despite the lack of home nursing.
© 2007 S. Karger AG, Basel
- Hewitt-Taylor J: Children who require long-term ventilation: staff education and training. Intensive Crit Care Nurs 2004;20:93–102.
- Amin RS, Fitton CM: Tracheostomy and home ventilation in children. Semin Neonatol 2003;8:127–135.
Keens TG, Jansen MT, DeWitt PK, et al: Home care for children with chronic respiratory failure. Semin Respir Med 1990;11:269–281.
Keens TG, Davidson Ward SL: Ventilatory treatment at home; in Ballard RA (ed): Pediatric Care of the ICN Graduate. Philadelphia, Saunders, 1988, pp 371–385.
- Smith CE, Mayer LS, Perkins SB, et al: Caregiver learning needs and reactions to managing home mechanical ventilation. Heart Lung 1994;23:157–163.
O’Donohue WJ, Giovannoni RM, Goldberg AI, et al: Long-term mechanical ventilation: guidelines for management in the home and at alternate community sites: report of the ad hoc committee, Respiratory Care Section, American College of Chest Physicians. Chest 1986;90(suppl):1S–37S.
- Fauroux B, Boffa C, Desguerre I, Estournet B, Trang H: Long-term noninvasive mechanical ventilation for children at home: a national survey. Pediatr Pulmonol 2003;35:119–125.
Adams AB, Shapiro R, Marinii JJ: Changing prevalence of chronically ventilator-assisted individuals in Minnesota: increases, characteristics, and the use of non-invasive ventilation. Respir Care 1998;43:635–636.
- Jardine E, O’Toole M, Paton JY, Wallis C: Current status of long-term ventilation of children in the United Kingdom: questionnaire survey. BMJ 1999;318:295–299.
- Kamm M, Burger R, Rimensberger P, Knoblauch A, Hammer J: Survey of children supported by long-term mechanical ventilation in Switzerland. Swiss Med Wkly 2001;131:261–266.
Dhillon J, Frewen T, Singh N, Speechley K: Chronic mechanical dependent children in Canada. J Paediatr Child Health 1996;1:111–116.
Roussos C, Macklem PT: Inspiratory muscle fatigue; in The Handbook of Physiology, section 3: The Respiratory System. Baltimore, American Physiological Society, 1986, vol III, part 2, pp 649–690.
- Fauroux B, Sardet A, Foret D: Home treatment for chronic respiratory failure in children: a prospective study. Eur Respir J 1995;8:2062–2066.
- Frangolias D, Wilcox PG: Predictability of oxygen desaturation during sleep in patients with cystic fibrosis. Chest 2001;119:434–441.
- Uyan ZS, Ozdemir N, Ersu R, Akpınar I, Keskin S, Cakır E, Karadag B, Karakoc F, Daglı E: Factors that correlate with sleep oxygenation in children with cystic fibrosis. Pediatr Pulmonol 2007;42:716–722.
- Kremer B, Botos-Kremer AI, Eckel HE, Schlöndorff G: Indications, complications, and surgical techniques for pediatric tracheostomies – an update. J Pediatr Surg 2002;37:1556–1562.
- Hoskote A, Cohen G, Goldman A, Shekerdemian L: Tracheostomy in infants and children after cardiothoracic surgery: indications, associated risk factors, and timing. J Thorac Cardiovasc Surg 2005;130:1086–1093.
- Messineo A, Giusti F, Narne S, Mognato G, Antoniello L, Guglielmi M: The safety of home tracheostomy care for children. J Pediatr Surg 1995;30:1246–1248.
- Bahng SC, VanHala S, Nelson VS, Hurvitz EA, Roloff DW, Grady EA, Lewis CC: Parental report of pediatric tracheostomy care. Arch Phys Med Rehabil 1998;79:1367–1369.
Lane R, Laverty A, Gonsalez S, Wallis CE, Dinwiddie RD: Five-year experience of nasal-continuous positive pressure (CPAP) in the treatment of upper airway obstruction (UAO) during sleep in children. Eur Respir J 1998;12:S4.
- McNamara F, Sullivan CE: Obstructive sleep apnea in infants and its management with nasal continuous positive airway pressure. Chest 1999;116:10–16.
- Shneerson JM: Home mechanical ventilation in children: techniques, outcomes and ethics. Monaldi Arch Chest Dis 1996;51:426–430.
Teague WG: Pediatric application of non-invasive ventilation. Respir Care 1997;424:414–423.
- Simonds AK, Ward S, Heather S, Bush A, Muntoni F: Outcome of paediatric domiciliary mask ventilation in neuromuscular and skeletal disease. Eur Respir J 2000;16:476–481.
- Li KK, Riley RW, Guilleminault C: An unreported risk in the use of home nasal continuous positive airway pressure and home nasal ventilation in children. Chest 2000;117:916–918.
- Fauroux B, Lavis JF, Nicot F, et al: Facial side effects during non-invasive positive pressure ventilation in children. Intensive Care Med 2005;31:965–969.
- Patterson JM, Leonard BJ, Titus JC: Home care for medically fragile children: impact on family health and well-being. J Dev Behav Pediatr 1992;13:248–255.
- Tsara V, Seraslı E, Voutsas, Lazarides V, Christaki P: Burden and coping strategies in families of patients under noninvasive home mechanical ventilation. Respiration 2006;73:61–67.
- Fraser J, Henrichsen T, Mok Q, et al: Prolonged mechanical ventilation as a consequence of acute illness. Arch Dis Child 1998;78:253–256.
Jardine E, Wallis C: Core guidelines for the discharge home of the child on long-term assisted ventilation in the United Kingdom. UK Working Party on Paediatric Long Term Ventilation. Thorax 1998;53:762–767.
- Noyes J: Barriers that delay children and young people who are dependent on mechanical ventilators from being discharged from hospital. J Clin Nurs 2002;11:2–11.
- Noyes J: Enabling young ‘ventilator-dependent’ people to express their views and experiences of their care in hospital. J Adv Nurs 2000;31:1206–1215.
- Srinivasan S, Doty SM, White TR, Segura VH, Jansen MT, Davidson Ward SL, et al: Frequency, causes, and outcome of home ventilator failure. Chest 1998;114:1363–1367.
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