Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jan 31;46(1):12.
doi: 10.1186/s13052-020-0778-8.

Characteristics and outcomes in children on long-term mechanical ventilation: the experience of a pediatric tertiary center in Rome

Martino Pavone  1 , Elisabetta Verrillo  2 , Alessandro Onofri  2 , Serena Caggiano  2 , Maria Beatrice Chiarini Testa  2 , Renato Cutrera  2
Affiliations

Characteristics and outcomes in children on long-term mechanical ventilation: the experience of a pediatric tertiary center in Rome

Martino Pavone et al. Ital J Pediatr. .

Abstract

Background: Children with chronic respiratory failure and/or sleep disordered breathing due to a broad range of diseases may require long-term ventilation to be managed at home. Advances in the use of long-term non-invasive ventilation has progressively leaded to a reduction of the need for invasive mechanical ventilation through tracheostomy. In this study, we sought to characterize a cohort of children using long-term NIV and IMV and to perform an analysis of those children who showed significant changes in ventilatory support management.

Methods: We performed a retrospective cohort study of pediatric (within 18 years old) patients using long-term, NIV and IMV, hospitalized in our center between January 1, 2000 and December 31, 2017. A total of 432 children were included in the study. Long Term Ventilation (LTV) was defined as IMV or NIV, performed on a daily basis, at least 6 h/day, for a period of at least 3 months.

Results: 315 (72.9%) received non-invasive ventilation (NIV); 117 (27.1%) received invasive mechanical ventilation (IMV). Children suffered mainly from neuromuscular (30.6%), upper airway (24.8%) and central nervous system diseases (22.7%). Children on IMV were significantly younger when they start LTV [NIV: 6.4 (1.2-12.8) years vs IMV 2.1 (0.8-7.8) years] (p < 0.001)]. IMV was likely associated with younger age at starting ventilatory support (aOR 0.9428; p = 0.0220), and being a child with home health care (aOR 11.4; p < 0.0001). Overtime 39 children improved (9%), 11 children on NIV (3.5%) received tracheostomy; 62 children died (14.3%); and 74 children (17.1%) were lost to follow-up (17.8% on NIV, 15.4% on IMV).

Conclusions: Children on LTV suffered mainly from neuromuscular, upper airways, and central nervous system diseases. Children invasively ventilated usually started support younger and were more severely ills.

Keywords: Invasive mechanical ventilation; Long – term ventilation; Neuromuscular disorders; Non-invasive ventilation.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Annual incidence of subjects initiated on long-term mechanical ventilation during the study period
Fig. 2
Fig. 2
Major Diagnostic Categories and Types of Ventilation
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Amaddeo A, Frapin A, Fauroux B. Long-term non-invasive ventilation in children. Lancet Respir Med. 2016;4(12):999–1008. doi: 10.1016/S2213-2600(16)30151-5. - DOI - PubMed
    1. Simon TD, Cawthon ML, Stanford S, Popalisky J, Lyons D, Woodcox P, Hood M, Chen AY. Mangione-smith R; Center of Excellence on quality of care measures for children with complex needs (COE4CCN) medical complexity working group. Pediatric medical complexity algorithm: a new method to stratify children by medical complexity. Pediatrics. 2014;133(6):e1647–e1654. doi: 10.1542/peds.2013-3875. - DOI - PMC - PubMed
    1. Racca F, Bonati M, Del Sorbo L, Berta G, Sequi M, Capello EC, Wolfler A, Salvo I, Bignamini E, Ottonello G, et al. Invasive and non-invasive long-term mechanical ventilation in Italian children. Minerva Anestesiol. 2011;77(9):892–901. - PubMed
    1. Mandelzweig K, Leligdowicz A, Murthy S, Lalitha R, Fowler RA, Adhikari NKJ. Non-invasive ventilation in children and adults in low- and low-middle income countries: a systematic review and meta-analysis. J Crit Care. 2018;47:310–319. doi: 10.1016/j.jcrc.2018.01.007. - DOI - PubMed
    1. Wallis C, Paton JY, Beaton S, Jardine E. Children on long-term ventilatory support: 10 years of progress. Arch Dis Child. 2011;96(11):998–1002. doi: 10.1136/adc.2010.192864. - DOI - PubMed