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Updated: Oct 26, 2025
Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
Published on: August 24, 2019
Feasibility of long-term home noninvasive ventilation program in a general pediatric unit: 21 years' experience in
Yuk-Ping Tsang1,2, Ching-Yee To1,3, Cheuk-Kiu Tsui1
1Department of Paediatrics, Kwong Wah Hospital, Hong Kong, Hong Kong SAR.
Insights
Home noninvasive ventilation (NIV) for children with breathing disorders is effective in general hospitals. This study shows good adherence and outcomes, highlighting the importance of local hospital input for future healthcare planning.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Healthcare Management
Background:
- Long-term home noninvasive ventilation (NIV) is increasingly used for pediatric sleep-disordered breathing and chronic respiratory failure.
- While successful in tertiary centers, its implementation in general care settings is less understood.
- This study evaluates the clinical profiles of children on home NIV in a general pediatric unit over 20 years.
Purpose of the Study:
- To assess the feasibility and outcomes of long-term home noninvasive ventilation (NIV) in a general pediatric care setting.
- To analyze the clinical characteristics and adherence patterns of pediatric patients requiring home NIV.
- To inform healthcare planning regarding the growing demand for pediatric NIV services.
Main Methods:
- Retrospective review of patients under 18 years old receiving long-term home NIV.
- Data collected from a Hong Kong regional general pediatric unit between January 1, 1997, and December 31, 2017.
- Analysis of patient demographics, indications for NIV, NIV type, adherence, and program discontinuation.
Main Results:
- Home NIV use in children increased over tenfold in two decades, with 114 children initiated on NIV.
- Upper airway obstruction was the primary indication (77%), followed by neuromuscular diseases (16%).
- Continuous positive airway pressure (CPAP) was the most common NIV type (59%), with good adherence (increasing from 78.6% to 82.5%) and 46% remaining in the program.
Conclusions:
- Pediatric home NIV is a feasible and effective treatment in general care settings.
- Good patient adherence and outcomes support the integration of NIV services in local hospitals.
- Increased input from general hospitals is crucial for effective healthcare planning and meeting the growing demand for pediatric respiratory support.
Background:
Long-term home noninvasive ventilation (NIV) is increasingly employed in children with sleep-disordered breathing and chronic respiratory failure. While studies suggest its successful implementation in tertiary care centers, little is known about the situation in a general care setting. Hence, we aim to evaluate the clinical profiles of these children in a general pediatric unit over the past two decades.
Methods:
Data collected retrospectively on patients younger than 18 years old receiving long-term home NIV from January 1, 1997 to December 31, 2017 in a Hong Kong regional general pediatric unit were reviewed.
Results:
The number of children on home NIV increased more than 10-fold over the past two decades. In total, 114 children were commenced on NIV during the 21-year period. Upper airway obstruction was the most common cause (77%), followed by neuromuscular diseases (16%), pulmonary disorders (4%), and abnormal ventilatory control (3%). Continuous positive airway pressure was the most common NIV type (59%). To date, 46% of the children remained in our NIV program, while 18% discontinued NIV support. NIV adherence increased significantly with follow-up (median of 78.6% and 82.5% at baseline and last follow-up, respectively). Sixty-five percent of the children used NIV for at least 4 h on 70% of the days monitored. Higher body mass index was associated with lower adherence.
Conclusion:
Pediatric home NIV is feasible in the general care setting with good outcomes and adherence. As the demand for NIV service grows, input from local hospitals will be of increasing importance and should be considered upon healthcare planning.
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