‘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

Abstract

• 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.

Alternativas de tratamento para pacientes pediátricos em ventilação mecânica crônica

“…Milton Hanashiro, 1 Antonio O. C. Franco, 2 Alexandre A. Ferraro, 3 Eduardo J. Troster 4 the ICU by stable patients impairs the capacity to receive new patients with severe conditions, 5 besides the fact that it increases expenditure. 6 As an alternative to lengthy ICU stays, many patients have been transferred to services of lower complexity, such as mechanical ventilator dependency units (MVDUs).…”

“…2 This situation exposes patients and their families to problems associated with prolonged hospital stays, such as nosocomial infections, and also psychological 3,4 and relationship disturbances in the family. For the hospital, prolonged bed occupation in…”

Barriers that delay children and young people who are dependent on mechanical ventilators from being discharged from hospital

“…Increasing numbers of children and young people now survive life‐threatening illnesses and traumatic accidents with the aid of sophisticated computerized portable ventilators (Samuels, 1996). Whilst there is evidence that the use of mechanical ventilation can bring about considerable health gain, Noyes (2000) reported concerns that this group of children and young people were frequently remaining in hospital when they no longer had a medical need or wanted to be there.…”

“…In summary, Noyes (2000) found that once medically stable, the children and young people did not want to remain in a hospital environment. Living in hospital for prolonged periods of time had a profound and negative impact on the children and their families.…”

“…It was considered beyond the scope of the first paper (Noyes, 2000) to analyse the barriers that prevented these children and young people from being discharged home. This second paper reports on the barriers that interviewees described as important factors in the discharge of `ventilator‐dependent' children and young people from hospital.…”