Changes in UK paediatric long-term ventilation practice over 10 years

Area of Science:

• Pediatric respiratory medicine
• Critical care
• Public health

Background:

• Long-term ventilation (LTV) is a critical support for children with chronic respiratory failure.
• Understanding current trends in pediatric LTV is essential for service planning and resource allocation.
• Previous data from 10 and 20 years prior provide a baseline for comparison.

Purpose of the Study:

• To present current data on pediatric LTV use in the UK.
• To compare contemporary LTV practices with historical data.
• To identify trends in patient populations, ventilation methods, and therapeutic interventions.

Main Methods:

• A national census of UK pediatric LTV centers was conducted.
• An online survey collected data at a single timepoint.
• The study included all patients accessing pediatric LTV services across the UK.

Main Results:

• A 2.5-fold increase in pediatric LTV use was observed over 10 years, with 2383 children included.
• Increased LTV use was noted for central hypoventilation syndrome (mask ventilation), spinal muscular atrophy type 1, chronic lung disease of prematurity, and airway obstruction.
• Decreased use of 24-hour ventilation, negative pressure ventilation, and tracheostomy interfaces was reported. Disease-modifying drugs influenced LTV initiation in some cases, particularly nusinersen for SMA type 1.

Conclusions:

• The significant increase in pediatric LTV necessitates updated national data collection.
• Establishing a national database is crucial for informing future recommendations and planning resource allocation for pediatric LTV.
• Current trends indicate evolving patient profiles and ventilation strategies in pediatric LTV.