title: Invasive and non-invasive long-term mechanical ventilation in Italian children.
abstract: BACKGROUND
  To date, few studies have been published regarding the number of children in Italy who require long-term mechanical ventilation (LTV) and their underlying diagnoses, ventilatory needs and hospital discharge rate.
  
  
  METHODS
  A preliminary national postal survey was conducted and identified 535 children from 57 centers. Detailed data were then obtained for 378 children from 30 centers.
  
  
  RESULTS
  The estimated prevalence in Italy of this population was 4.3/100000. The majority of children (72.2%) were followed in pediatric units. The primary physicians who cared for these patients were either pediatric intensivists or pediatric pulmonologists. Neurological patients (78.2% of cases) represented the principal disorder category. 57.2% of the patients were non-invasively ventilated, with a nasal mask being the most common interface (85% of cases). The presence of clinical symptoms that were associated with abnormal findings on diagnostic testing was the primary indication for ventilatory support, whereas weaning failure was the primary indication for tracheotomy. Invasive ventilation was significantly related to younger age, longer daily hours on ventilation and cerebral palsy. Ventilatory modes with guaranteed minimal tidal volume were more often used in patients with tracheotomy. Despite their age, illness severity and need for technological care, 98% of the study population were successfully home discharged.
  
  
  CONCLUSIONS
  Managing pediatric home LTV requires tremendous effort on the part of the patient's family and places a significant strain on community financial resources. In particular, neurological patients require more health care than patients in other categories. To further improve the quality of care for these patients, it is essential to establish a dedicated national database.
authors: Department of Pediatric Anesthesia and Resuscitation, SS Antonio Biagio e Cesare Arrigo Hospital, Alessandria, Italy. fabrizio.racca@gmail.com
authors: F
authors: F
authors: Racca
authors: M
authors: M
authors: Bonati
authors: L
authors: L
authors: Del Sorbo
authors: G
authors: G
authors: Berta
authors: M
authors: M
authors: Sequi
authors: E C
authors: EC
authors: Capello
authors: A
authors: A
authors: Wolfler
authors: I
authors: I
authors: Salvo
authors: E
authors: E
authors: Bignamini
authors: G
authors: G
authors: Ottonello
authors: R
authors: R
authors: Cutrera
authors: P
authors: P
authors: Biban
authors: F
authors: F
authors: Benini
authors: V M
authors: VM
authors: Ranieri
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003627:Data Interpretation, Statistical; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D016015:Logistic Models; D008297:Male; D012121:Respiration, Artificial; D012129:Respiratory Function Tests; D011795:Surveys and Questionnaires; D014139:Tracheostomy / Q000706:statistics & numerical data; D015300:Ventilator Weaning