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Experience in a Pediatric Prolonged Mechanical Ventilation Unit from a public hospital in Chile
Daniel Zenteno1,2, Gerardo Torres-Puebla1,3, Ximena Navarro1
1Unidad de Ventilación Mecánica Prolongada, Servicio de Pediatría, Hospital Guillermo Grant Benavente, Concepción, Chile.
Insights
Pediatric Prolonged Mechanical Ventilation Units (PMVU) manage children with high respiratory technology dependency. Invasive ventilation in children leads to longer hospital stays and increased readmissions, highlighting the need for specialized care strategies.
Area of Science:
- Pediatric critical care medicine
- Respiratory medicine
- Health services research
Background:
- Hospitalized children with significant respiratory technology needs are increasing.
- Effective strategies for managing these complex cases are limited.
- Prolonged mechanical ventilation requires specialized care environments.
Purpose of the Study:
- To evaluate the 6-year experience of a dedicated Pediatric Prolonged Mechanical Ventilation Unit (PMVU).
- To analyze patient demographics, pathologies, and resource utilization within the unit.
- To identify factors associated with length of stay and readmissions.
Main Methods:
- Retrospective study of all pediatric admissions to the PMVU from October 2012 to December 2018.
- Descriptive and inferential statistical analyses were performed.
- Outcomes were compared based on patient pathology and ventilation type.
Main Results:
- The unit managed 113 patients over 310 admissions, with a high occupancy rate (92.6%).
- Neurological damage (34.5%) and neuromuscular disease (22.1%) were common pathologies.
- Invasive ventilation was associated with significantly longer lengths of stay and higher readmission rates (p < 0.001).
Conclusions:
- The PMVU maintained high occupancy, potentially freeing up intensive care unit beds.
- Children requiring invasive ventilation experienced prolonged hospitalizations and more readmissions.
- Specialized units like the PMVU are crucial for managing pediatric patients with prolonged mechanical ventilation needs.
Introduction:
Hospitalized patients with high respiratory technology dependency are increasingly common and result in lengthy stays in intensive care units. Strategies mitigating its impact have been scarcely described.
Objective:
To describe a 6-year experience in a Pediatric Prolonged Mechanical Ventilation Unit.
Methods:
Retrospective study. All children admitted to the unit between October 2012 and December 2018 were included. Descriptive and inferential statistical methods were used, analyzing lengths of stay and readmissions. Different outcome measures were compared according to the type of pathology and mechanical ventilation.
Results:
A total of 113 patients had 310 admissions to the unit. Age at admission: 2.2 years (0.6-8.8); males: 60.2 %.
Pathologies:
neuromuscular disease (22.1 %), chronic lung disease (20.4 %), neurological damage (34.5 %), upper airway obstruction (9.7 %), heart disease (3.5 %), Down syndrome (9.7 %). A total of 10 507 bed-days were used; with a 92.6 % occupancy rate, 54.8 % of transfers to the intensive care unit, and 66.1 % of readmissions. Mean length of stay: 16 days (6.5- 49.0); differences in age at admission observed by pathology (p = 0.032). More readmissions were observed in children with neurological damage and Down syndrome (p = 0.004). Children with invasive ventilation were observed to have a longer length of stay (p < 0.001) and more readmissions (p < 0.001).
Conclusion:
The occupancy rate at the PMVU was over 90 %, which allowed more available intensive care beds and discharging all patients. Children with invasive ventilation had a longer length of stay and more readmissions.
