Pediatric invasive long-term ventilation-A 10-year review

Area of Science:

• Pediatric critical care
• Respiratory medicine
• Healthcare resource management

Background:

• The survival of children with complex pathologies, including chronic respiratory insufficiency, is increasing.
• There is a lack of data on the clinical pathway for children requiring invasive long-term mechanical ventilation (LTMV) in Ireland.
• This study examines Irish trends in pediatric LTMV to compare with global patterns.

Purpose of the Study:

• To analyze the clinical pathway and outcomes of children on invasive long-term mechanical ventilation (LTMV) in an Irish tertiary pediatric hospital.
• To identify longitudinal trends in the initiation and management of LTMV over a 10-year period.
• To assess changes in decannulation success rates for pediatric patients requiring LTMV.

Main Methods:

• A retrospective review of data from Children's Health Ireland (CHI) at Crumlin, Dublin.
• Analysis of children commenced on LTMV via tracheostomy between 2009 and 2018.
• Data divided into two epochs to evaluate longitudinal trends.

Main Results:

• Forty-six children were commenced on LTMV between 2009-2018, many with complex comorbidities.
• A significant decrease (30.4%) in new LTMV initiations was observed in the latter half of the study period.
• Children starting LTMV later in the decade showed improved treatment outcomes and shorter decannulation times.

Conclusions:

• Fewer children required LTMV annually over the 10-year period.
• Successful weaning and decannulation rates for LTMV patients have improved.
• These trends have significant implications for predicting future healthcare needs and resource allocation for pediatric and adult services.