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Children on long-term ventilatory support: 10 years of progress
C Wallis1, J Y Paton, S Beaton
1UCL Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK. c.wallis@ich.ucl.ac.uk
Archives of Disease in Childhood
|November 27, 2010
Summary
The UK has seen a significant rise in children needing long-term ventilation (LTV), with most cared for at home. This trend highlights advancements in technology and care for pediatric respiratory support.
Area of Science:
- Pediatric Respiratory Medicine
- Medical Technology Assessment
Background:
- Long-term ventilation (LTV) in children has seen significant growth.
- Understanding the epidemiology of pediatric LTV is crucial for resource allocation and service planning.
Purpose of the Study:
- To determine the number and geographical distribution of children requiring LTV in the UK.
- To identify the primary diagnoses and specific ventilatory needs of these children.
Main Methods:
- A single time-point census was conducted across 30 UK regional centers.
- An electronic questionnaire was utilized, completed by members of the UK LTV working party.
- The study included children requiring mechanical breathing assistance beyond a 3-month period when medically stable.
Main Results:
- 933 children under 17 years were identified as receiving LTV.
- The majority (75%) used non-invasive mask ventilation, with 22% using tracheostomy.
- Common underlying conditions included neuromuscular (43%), chronic respiratory (37%), and central nervous system disorders (18%).
- Most children (91%) were managed at home, with only a small fraction in acute or intensive care units.
Conclusions:
- There has been a substantial increase in pediatric LTV in the UK over the past decade.
- This increase is attributed to improved technology, clinical expertise in non-invasive support, and evolving attitudes towards long-term care.
- A significant challenge exists regarding the transition of these children to adult services, which are currently underdeveloped.
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