Home Ventilation for Children with Chronic Respiratory Failure in Istanbul

Abstract

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.

Alternativas de tratamento para pacientes pediátricos em ventilação mecânica crônica

“…[7][8][9][10] Patients who have favorable clinical and socioeconomic conditions may be indicated for home mechanical ventilation (HMV). 7,[11][12][13][14][15][16][17][18] There are no data available about bed occupation and length of stay associated with patients who require MVDU or HMV in developing countries. In Brazil, few services offer prolonged mechanical ventilation for pediatric patients.…”

Care alternatives for pediatric chronic mechanical ventilation

“…Pacientes que apresentam condições clínicas e socioeconômicas favoráveis podem ser indicados para receber ventilação mecânica domiciliar (VMD) 7,[11][12][13][14][15][16][17][18] .…”

Home Mechanical Ventilation in Children: Erciyes University Experience

“…(10) 36 hasta ile yaptıkları çalışmada ortalama YBÜ yatış gün sayısının 154±150 gün, hastalar klinik olarak stabil hale geldikten sonra ise 107±124 gün olduğunu belirtmişlerdir. Ülkemizde yapılan bir çalışmasında ise EMV temini noktasında yaşanan sıkıntılar nedeniyle hastaların ortalama 64 gün fazladan YBÜ'de yattığı belirtilmiştir (4). Çalışmamızda ise hastaların ortalama YBÜ yatış gün sayısı 75 gün (44-115) olarak hesaplanmış, nörolojik hastalığı olanların akciğer hastalığı olanlara nazaran YBÜ yatış sürelerinin daha uzun olduğu görülmüştür.…”