Arrangement of residence before hospital discharge for children on home‐invasive mechanical ventilation

Abstract

Children on long‐term home mechanical ventilation are a growing population due to clinical and technological advances and the benefit for the child's quality of life. Invasive home ventilation is one of the most complex therapies offered in the home setting, requiring adequate home environment and appropriate equipment and supplies before discharge. The transition from hospital to home represents a vulnerable period that can be facilitated with an established transition plan with multidisciplinary team involvement. Readiness for home care is achieved when the patient is stable and has been transitioned from a critical care ventilator to a home mechanical ventilator. In parallel, comprehensive competency‐based training regarding the knowledge and skills needed to help families use the equipment confidently and safely. Before discharge, families should be counseled on an adequate home environment to ensure a safe transition. The residence arrangement may include physical space modifications, verifying electrical installation, or moving to another home. Durable medical equipment and supplies must be ordered, and community healthcare support arranged. Parents should receive practical advice on setting up the equipment at home and on preventive measures to minimize complications related to tracheostomy and ventilator dependence, including regular maintenance and replacement of necessary equipment. Given the overall impact of invasive ventilation on home life, a structured home care action package is essential to alleviate the burdens involved.

Multidisciplinary management of pediatric patients on home invasive mechanical ventilation

“…Selecting which children and families will benefit from HIMV is important and requires meticulous preparation to ensure feasibility and safety in the home setting. In this special issue, Bayav et al 1 discuss indications for HIMV and describe patient monitoring, and benefits of offering HIMV; Henningfeld et al 2 outline essential factors in determining discharge from hospital readiness such as medical stability, caregiver competence, and home environment suitability; Zirek et al 3 emphasize the critical role of caregiver education regarding the knowledge and skills they must acquire to use the equipment confidently and safely; Torrent-Vernetta et al 4 discuss how the home environment should be modified before hospital discharge and other essential equipment needs.…”