Risk factors for morbidity and mortality in pediatric home mechanical ventilation.
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.


METHODS
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.
Kinderklinik und Kinderpoliklinik der Universität München, Lindwurmstrasse 4, Munich, Germany. karl.reiter@med.uni-muenchen.de
Karl
K
Reiter
Nadine
N
Pernath
Philipp
P
Pagel
Stephan
S
Hiedi
Florian
F
Hoffmann
Carola
C
Schoen
Thomas
T
Nicolai
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004630:Emergencies; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008397:Masks / Q000009:adverse effects; D009017:Morbidity; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000401:mortality; D012131:Respiratory Insufficiency / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D014139:Tracheostomy / Q000009:adverse effects; D055815:Young Adult