Clinical Evaluation of Invasive Home Mechanical Ventilation Dependent Pediatric Patients

Objectives: With the advancements in neonatal and pediatric intensive care services and technology, the number of children requiring long term mechanical ventilation support is increasing. Home mechanical ventilators enable discharge of patients with chronic respiratory failure from hospital and allows children to grow in natural environment. The objective of this study was to define clinical characteristics and follow up results of pediatric patients who are dependent on invasive home mechanical ventilation support. Methods: This retrospective study included a total of 61 patients discharged from pediatric intensive care unit while on mechanical ventilation (HMV). Results: The median age of patients was 8.5 (2 - 196) months with 60% of them being younger than 12 months. The decision for HMV was made after median 38 +/- 37.2 days of mechanical ventilation in hospital. The most common reason of dependency on invasive HMV was found as central nervous system and neuromuscular diseases by 94%. The median duration of follow up was 11 months (4 days-7.5 years). HMV was no longer necessary in 12% of patients ventilated for neurological reasons and 50% for chronic pulmonary diseases. Anthropometric measures were observed to be improved in 69% of the patients. Mortality rate attributed to complications of tracheostomy was 15% and overall mortality was found as 46.7%. Conclusions: HMV enables ventilator dependent patients to be discharged and allows patients to develop and grow in their natural environment which helps them to catch up their growth potentials. The survival and quality of life (QoL) of these patients can be improved by family education and with the support by nutrition and care rehabilitation programs.