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Rapid Response and Code Events in Hospitalized Children on Home Mechanical Ventilation

Sheila S Kun1, Alexis D Deavenport-Saman2, Thomas G Keens3

  • 1Division of Pulmonology skun@chla.usc.edu.

Respiratory Care
|October 24, 2019
PubMed

Insights

Children on home mechanical ventilation (HMV) had more rapid-response and code events than other hospitalized children. Those preparing for discharge experienced the most events, often requiring ventilator or tracheostomy interventions.

Area of Science:

  • Pediatric critical care
  • Respiratory medicine
  • Home healthcare

Background:

  • Limited data exists on rapid-response (RR) and code events in children on home mechanical ventilation (HMV) via tracheostomy in non-ICU settings.
  • Understanding these events is crucial for improving patient safety and care protocols.

Purpose of the Study:

  • To describe demographic and clinical factors associated with deterioration in HMV patients.
  • To determine the incidence and outcomes of RR and code events in this population.

Main Methods:

  • Retrospective review of hospitalized children receiving HMV.
  • Analysis of RR/code events within a non-ICU respiratory care unit.

Main Results:

  • HMV patients experienced higher RR (8.73/1000 days) and code event (3.14/1000 days) rates compared to non-HMV patients.
  • Children awaiting initial home discharge had the highest incidence of RR (40%) and code (56%) events.
  • Ventilator adjustments were common for RR events, while tracheostomy interventions were frequent for code events.

Conclusions:

  • Children on HMV have a higher incidence of RR/code events, particularly those nearing discharge.
  • Ventilator and tracheostomy management are key interventions for these events.
  • Predictive strategies for RR/code events could reduce harm in HMV patients.
Abstract

Keywords:
code eventhome mechanical ventilationhospitalized childrenincidence ratenon-ICU respiratory care unitpediatricsrapid-response event

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