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Review
. 2022 Nov 5;9(11):1700.
doi: 10.3390/children9111700.

Long-Term Ventilation in Children with Medical Complexity: A Challenging Issue

Valeria Caldarelli  1 , Federica Porcaro  2 , Paola Di Filippo  3 , Marina Attanasi  3 , Valentina Fainardi  4 , Marcella Gallucci  5 , Angelo Mazza  6 , Nicola Ullmann  2 , Stefania La Grutta  7
Affiliations
Review

Long-Term Ventilation in Children with Medical Complexity: A Challenging Issue

Valeria Caldarelli et al. Children (Basel). .

Abstract

Children with medical complexity (CMCs) represent a subgroup of children who may have congenital or acquired multisystemic disease. CMCs are frequently predisposed to respiratory problems and often require long-term mechanical ventilation (LTMV). The indications for LTMV in CMCs are increasing, but gathering evidence about indications, titration, and monitoring is currently the most difficult challenge due to the absence of validated data. The aim of this review was to examine the clinical indications and ethical considerations for the initiation, continuation, or withdrawal of LTMV among CMCs. The decision to initiate long-term ventilation should always be based on clinical and ethical considerations and should be shared with the parents.

Keywords: children with medical complexity; continuous positive airway pressure; ethical issues; long-term invasive mechanical ventilation; palliative care; sleep apnea syndrome; sleep-disordered breathing.

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Conflict of interest statement

The authors declare no conflict of interest.

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