title: Thirteen years of invasive and noninvasive home ventilation for children in a developing country: A retrospective study.
abstract: Home ventilation (HV) for children is growing rapidly worldwide. The aim was to describe (1) the sociodemographic characteristics of children on HV and (2) the indications for, means and outcome of initiating HV in children from a developing country.
  
  
  
  This retrospective study included patients sent home on noninvasive or invasive ventilation, over 13 years, by the pediatric respiratory unit in a single center. Children who declined treatment were excluded.
  
  
  
  Seventy children were initiated on HV: 85.7% on noninvasive ventilation, 14.3% on invasive ventilation. There was about a threefold increase from 2001-2008 (n = 18) to 2009-2014 (n = 52). Median (range) age of initiating HV was 11 (1-169) months and 73% of children were <2 years old. Common indications for HV were respiratory (57.2%), chest/spine anomalies (11.4%), and neuromuscular (10.0%). Fifty-two percent came off their devices with a median (interquartile range) usage duration of 12 (4.8, 21.6) months. Ten children (14.3%) died with one avoidable death. Children with neuromuscular disease were less likely to come off their ventilator (0.0%) compared to children with respiratory disease (62.1%). Forty-one percent of parents bought their equipment, whereas 58.6% borrowed their equipment from the medical social work department and other sources.
  
  
  
  HV in a resource-limited country is possible. Children with respiratory disease made up a significant proportion of those requiring HV and were more likely to be weaned off. The mortality rate was low. The social work department played an important role in facilitating early discharge. Pediatr Pulmonol. 2017;52:500-507. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Pediatrics, University of Malaya, Kuala Lumpur, Malaysia.|University Malaya Pediatric and Child Health Research Group, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Anna Marie
authors.initials: AM
authors.lastname: Nathan
authors.affiliation: University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Hui Yan
authors.initials: HY
authors.lastname: Loo
authors.affiliation: Department of Pediatrics, University of Malaya, Kuala Lumpur, Malaysia.|University Malaya Pediatric and Child Health Research Group, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Jessie Anne
authors.initials: JA
authors.lastname: de Bruyne
authors.affiliation: Department of Pediatrics, University of Malaya, Kuala Lumpur, Malaysia.|University Malaya Pediatric and Child Health Research Group, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Kah Peng
authors.initials: KP
authors.lastname: Eg
authors.affiliation: Department of Pediatrics, Universiti Putra Malaysia, Serdang, Malaysia.
authors.forename: Sze Ying
authors.initials: SY
authors.lastname: Kee
authors.affiliation: Department of Pediatrics, University of Malaya, Kuala Lumpur, Malaysia.|University Malaya Pediatric and Child Health Research Group, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Surendran
authors.initials: S
authors.lastname: Thavagnanam
authors.affiliation: Ministry of Health, Malaysia.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Bouniu
authors.affiliation: University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Jiat Earn
authors.initials: JE
authors.lastname: Wong
authors.affiliation: Department of Pediatrics, University of Malaya, Kuala Lumpur, Malaysia.|University Malaya Pediatric and Child Health Research Group, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Chin Seng
authors.initials: CS
authors.lastname: Gan
authors.affiliation: Department of Pediatrics, University of Malaya, Kuala Lumpur, Malaysia.|University Malaya Pediatric and Child Health Research Group, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Lucy Chai See
authors.initials: LC
authors.lastname: Lum
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D006699:Home Care Services; D006801:Humans; D007223:Infant; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D063087:Noninvasive Ventilation / Q000706:statistics & numerical data; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012131:Respiratory Insufficiency / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies; D012959:Socioeconomic Factors
keywords: BIPAP; CPAP; Malaysia; child; home ventilation; oxygen