Related Experiment Videos
Long-term ventilation in children: longitudinal trends and outcomes
Catherine M McDougall1, Robert J Adderley, David F Wensley
1Department of Respiratory Paediatrics, Royal Hospital for Sick Children, Sciennes Road, Edinburgh EH9 1LF, UK. catherine.mcdougall@nhs.net
Archives of Disease in Childhood
|July 11, 2013
Summary
The number of children requiring long-term ventilation (LTV) significantly increased over 15 years, driven by non-invasive ventilation (NIV). This growing paediatric population necessitates future service planning for both pediatric and adult care.
Area of Science:
- Pediatric Respiratory Medicine
- Longitudinal Health Trends
- Ventilatory Support
Background:
- Limited longitudinal data exists on the expansion of pediatric long-term ventilation (LTV).
- Previous cross-sectional studies indicated a rapid increase in LTV over two decades.
Purpose of the Study:
- To analyze longitudinal trends in pediatric long-term ventilation.
- To assess changes in incidence, prevalence, and survival rates for children on LTV.
Main Methods:
- Prospective data collection over a 15-year period (1995-2009).
- Inclusion of all patients receiving LTV in a single regional referral center.
- Analysis of invasive and non-invasive ventilation (NIV) use and patient outcomes.
Main Results:
- Significant increase in LTV incidence and a 10-fold rise in prevalence, primarily due to NIV.
- No significant increase in invasive ventilation rates.
- High overall survival rates (94% at 5 years, 91% at 10 years), with better survival for NIV patients.
- Increasing transition of patients to adult services over time.
Conclusions:
- The pediatric LTV population has significantly expanded over 15 years.
- Future planning for pediatric and adult services must address the needs of this growing population.
- Non-invasive ventilation plays a key role in the increasing prevalence of LTV.
Related Concept Videos
01:19Factors Affecting Pulmonary Ventilation
Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
01:20Assessment of Ventilation I: Respiratory Rate
Assessment of Ventilation
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:15Respiratory Volumes
Respiratory volumes are crucial metrics, meticulously measured to quantify the air exchanged in and out of the lungs during various phases of the breathing cycle. These precise measurements are vital for assessing lung function, diagnosing respiratory conditions, and monitoring overall respiratory health. Each parameter provides specific insights into the mechanics of breathing and the functional capacity of the lungs.
Tidal Volume (TV) Tidal volume (TV) is the air inhaled or exhaled in a...
Tidal Volume (TV) Tidal volume (TV) is the air inhaled or exhaled in a...
01:29Assessment of Ventilation II: Respiratory Depth and Rhythm
Respiratory Depth
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
01:26Longitudinal Studies
Longitudinal studies are also widely used in other medical and social science fields. For instance, in cardiovascular research, they can monitor patients' health over decades to identify risk factors for heart disease, such as high cholesterol or smoking, and evaluate the long-term effectiveness of preventive measures. Similarly, in mental health studies, researchers might follow individuals from adolescence into adulthood to understand the development and progression of conditions like...
02:20Longitudinal Research
Sometimes we want to see how people change over time, as in studies of human development and lifespan. When we test the same group of individuals repeatedly over an extended period of time, we are conducting longitudinal research. Longitudinal research is a research design in which data-gathering is administered repeatedly over an extended period of time. For example, we may survey a group of individuals about their dietary habits at age 20, retest them a decade later at age 30, and then again...