Related Experiment Video
Updated: Mar 14, 2026
A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
Thirteen years of invasive and noninvasive home ventilation for children in a developing country: A retrospective
Anna Marie Nathan1,2, Hui Yan Loo3, Jessie Anne de Bruyne1,2
1Department of Pediatrics, University of Malaya, Kuala Lumpur, Malaysia.
Insights
Home ventilation for children is feasible in developing countries, with respiratory conditions being a common indication. Children with respiratory issues had a higher chance of successful weaning from home ventilation.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Global Health
Background:
- Home ventilation (HV) for children is increasingly utilized globally.
- Data on HV in developing countries remains limited.
- Understanding sociodemographics, indications, and outcomes is crucial.
Purpose of the Study:
- To describe sociodemographic characteristics of children on HV.
- To identify indications, methods, and outcomes of initiating HV in a developing country.
- To assess the feasibility and impact of HV in resource-limited settings.
Main Methods:
- Retrospective study of pediatric patients initiated on noninvasive or invasive ventilation.
- Data collected over 13 years from a single pediatric respiratory unit.
- Exclusion of children who declined treatment.
Main Results:
- Seventy children initiated on HV, predominantly noninvasive (85.7%).
- Significant increase in HV use from 2001-2008 to 2009-2014.
- Common indications: respiratory (57.2%), chest/spine anomalies (11.4%), neuromuscular (10.0%).
- 52% weaned off devices; 14.3% mortality rate.
- Children with respiratory disease were more likely to be weaned (62.1%) than those with neuromuscular disease (0.0%).
- Parental equipment purchase (41%) and borrowing (58.6%) were observed.
Conclusions:
- Home ventilation is achievable in resource-limited settings.
- Respiratory conditions are a major indication for pediatric HV.
- Low mortality and the role of social work in facilitating discharge were noted.
Introduction:
Home ventilation (HV) for children is growing rapidly worldwide. The aim was to describe (1) the sociodemographic characteristics of children on HV and (2) the indications for, means and outcome of initiating HV in children from a developing country.
Methodology:
This retrospective study included patients sent home on noninvasive or invasive ventilation, over 13 years, by the pediatric respiratory unit in a single center. Children who declined treatment were excluded.
Results:
Seventy children were initiated on HV: 85.7% on noninvasive ventilation, 14.3% on invasive ventilation. There was about a threefold increase from 2001-2008 (n = 18) to 2009-2014 (n = 52). Median (range) age of initiating HV was 11 (1-169) months and 73% of children were <2 years old. Common indications for HV were respiratory (57.2%), chest/spine anomalies (11.4%), and neuromuscular (10.0%). Fifty-two percent came off their devices with a median (interquartile range) usage duration of 12 (4.8, 21.6) months. Ten children (14.3%) died with one avoidable death. Children with neuromuscular disease were less likely to come off their ventilator (0.0%) compared to children with respiratory disease (62.1%). Forty-one percent of parents bought their equipment, whereas 58.6% borrowed their equipment from the medical social work department and other sources.
Conclusion:
HV in a resource-limited country is possible. Children with respiratory disease made up a significant proportion of those requiring HV and were more likely to be weaned off. The mortality rate was low. The social work department played an important role in facilitating early discharge. Pediatr Pulmonol. 2017;52:500-507. © 2016 Wiley Periodicals, Inc.
Related Concept Videos
01:23Mechanical Ventilation II: Invasive Ventilation
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
01:23Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...
01:29Mechanical Ventilation I: Indication and Settings
01:14Ventilatory Modes
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
01:20Assessment of Ventilation I: Respiratory Rate
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:
01:19Factors Affecting Pulmonary Ventilation
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...