Changes in UK paediatric long-term ventilation practice over 10 years

Abstract

Objectives: To provide up-to-date information on the use of long-term ventilation (LTV) in the UK paediatric population and to compare the results with data collected 10 and 20 years previously.

Design: A single timepoint census completed by LTV centres in the UK, carried out via an online survey.

Setting and patients: All patients attending paediatric LTV services in the UK.

Results: Data were collected from 25 LTV centres in the UK. The total study population was 2383 children and young people, representing a 2.5-fold increase in the last 10 years. The median age was 9 years (range 0-20 years). Notable changes since 2008 were an increase in the proportion of children with central hypoventilation syndrome using mask ventilation, an increase in overall numbers of children with spinal muscular atrophy (SMA) type 1, chronic lung disease of prematurity and cerebral palsy being ventilated, and a 4.2-fold increase in children using LTV for airway obstruction. The use of 24-hour ventilation, negative pressure ventilation and tracheostomy as an interface had declined. 115 children had received a disease-modifying drug. The use of ataluren and Myozyme did not influence the decision to treat with LTV, but in 35% of the children with SMA type 1 treated with nusinersin, the clinician stated that the use of this drug had or may have influenced their decision to initiate LTV.

Conclusion: The results support the need for national database for children and young people using LTV at home to inform future recommendations and assist in resource allocation planning.

Keywords: Paediatrics; Respiratory Medicine.