The population prevalence of children receiving invasive home ventilation in Utah

Abstract

Children requiring home mechanical ventilation (HMV) represent a select group of technology-dependent patients. We evaluated the prevalence of children using invasive HMV in Utah from 1996 to 2004. Residents of Utah, 16 years old and less ventilated via a tracheostomy between 1996 and 2004 were identified. Children ventilated in 1996 and 2004 were compared. Data including demographic information, diagnosis leading to HMV, and age at initiation were compared between the two groups. The prevalence of HMV in 1996 was 5.0/100,000 (95% CI: 4.4-8.1) and 6.3/100,000 (95% CI: 4.7-8.4) in 2004. Median age at initiation was 6.5 months (IQR: 1.3, 24.0). Sixty-one percent (n = 47) were male, 84% (n = 65) lived in an urban county, and 86% (n = 66) had public insurance. The most frequent diagnostic category was abnormal ventilatory control (n = 36, 47%), followed by chronic lung disease (n = 19, 25%), airway abnormalities (n = 12, 16%), and neuromuscular weakness (n = 10, 13%). Thirteen patients died (17%). The median length of HMV was 39 months (IQR: 15, 102). Diagnostic categories, age at initiation of HMV, and sex did not differ significantly over the 8 years. The prevalence of children requiring HMV differed very little between 1996 and 2004. Moreover, the diagnoses for which children received this therapy remained constant.