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Published on: July 14, 2023
Home mechanical ventilation in children is feasible in developing countries
Aleksandar Sovtic1, Predrag Minic, Miodrag Vukcevic
1Department of Pulmonology, Mother and Child Institute, Belgrade, Serbia. asovtic@eunet.rs
Summary
Pediatric home mechanical ventilation (HMV) is achievable in developing nations, requiring robust reimbursement and healthcare networks for successful implementation. This study highlights its feasibility and challenges in Serbia.
Area of Science:
- Pediatric Pulmonology
- Critical Care Medicine
- Health Economics
Background:
- Limited data exists on pediatric home mechanical ventilation (HMV) in low-income developing countries.
- National surveys from developed countries are available, but insights from developing nations are scarce.
Purpose of the Study:
- To assess the feasibility and characteristics of pediatric home mechanical ventilation (HMV) in a developing country context.
- To identify key factors influencing the implementation of HMV for children in Serbia.
Main Methods:
- A survey of 29 pediatric patients receiving long-term home mechanical ventilation (HMV) at the Mother and Child Institute of Serbia.
- Inclusion criteria included hypercapnia, nocturnal hypoventilation, or hypoxemia, confirmed by blood gas analysis and sleep monitoring.
- Patients received either invasive HMV via tracheostomy (11 patients) or non-invasive ventilation (18 patients).
Main Results:
- The average age for initiating HMV was 9.3 years, with a mean waiting period of 6.3 months.
- Patients received HMV for an average of 25.06 months, with duration varying significantly by underlying disease (P=0.046).
- Mechanical malfunction was significantly dependent on the duration of HMV (P=0.011).
Conclusions:
- Home mechanical ventilation (HMV) is a feasible intervention in developing countries.
- Effective reimbursement policies and a well-organized healthcare network are crucial for establishing HMV as standard pediatric care.
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