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[A brief respite from hospital: home mechanical ventilation for children in Japan]
Insights
Home mechanical ventilation enables children needing respiratory support to spend valuable time at home. This approach fosters social and emotional development and improves family integration for pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Biomedical Engineering
- Rehabilitation Medicine
Context:
- Prolonged respiratory support often confines children to hospitals, limiting family time.
- Home mechanical ventilation is an emerging concept in Japan for pediatric care.
- Portable ventilators offer a viable option for home-based respiratory support.
Purpose:
- To evaluate the feasibility and impact of home mechanical ventilation for children in Japan.
- To assess the safety and effectiveness of using portable ventilators for pediatric home care.
- To explore the benefits of home ventilation on children's development and family dynamics.
Summary:
- Five pediatric cases utilized portable mechanical ventilation (Bennett, Companion 2800) for home use.
- Patients included those with hypoxic ischemic encephalopathy and various neuro-muscular diseases.
- Parents received training, enabling successful excursions and home stays, with increasing independence over time.
Impact:
- Home mechanical ventilation significantly accelerated social and emotional development in children, particularly those with neuro-muscular conditions.
- Facilitated greater family acceptance and familiarity with the child requiring respiratory support.
- Enabled children to engage in community activities like park visits, zoos, and museums, improving quality of life.
Abstract:
Children who require prolonged respiratory support often have to spend their whole lives in the hospital. It is important, however, for these children to have time with their families in their own homes. Home mechanical ventilation can make it possible. In Japan, the concept of home mechanical ventilation has just begun to open up. We reported five cases of home mechanical ventilation for children by using a portable respirator (Bennett, Companion 2800). Two cases of these were patients with hypoxic ischemic encephalopathy. The others were cases with neuro-muscular diseases (Werdnig-Hoffmann disease, mitochondrial myopathy, myotubular myopathy). Before taking the patients out, parents received a training in nursing procedures and in skillful use of the ventilator and equipment. The patients went out on excursions 17 times, and were released for home stay a total of 25 times. Initially, 12 excursions were undertaken with doctors or nurses in attendance; later, however, all of the home stays and 5 of the excursions were carried out successfully by the family only. They went to places such as their own home, a park, a zoo, an aquarium and a museum. The average time was 4.6 hours (3-8 hours) for excursions, and 1.8 days (1-7 days) for home stays. Questioning of family revealed that home mechanical ventilation accelerated the social and emotional development of these children whose condition necessitated respiratory support, especially patients with neuro-muscular diseases. It also revealed that family could accept the patient as a member with more familiarity and with more ease.(ABSTRACT TRUNCATED AT 250 WORDS)