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Transition from intensive care unit to a portable ventilator in children with severe bronchopulmonary dysplasia

Robin L McKinney1, Amit Agarwal2

  • 1Department of Pediatrics, Division of Pediatric Critical Care Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.

Pediatric Pulmonology
|December 13, 2022
PubMed

Insights

Caring for ventilator-dependent children at home requires careful planning. This review guides clinicians on transitioning children from hospital to home ventilators, focusing on readiness assessment and optimal settings for chronic respiratory support.

Area of Science:

  • Pediatrics
  • Pulmonology
  • Biomedical Engineering

Background:

  • Increasing population of ventilator-dependent children (VDC) with tracheostomies due to bronchopulmonary dysplasia necessitates home care.
  • Transitioning VDC from hospital to home is complex, requiring medical team and family coordination.
  • Moving from Intensive Care Unit (ICU) ventilators to portable home ventilators (PHV) is a critical step.

Purpose of the Study:

  • To review approaches for assessing VDC readiness for home transition.
  • To detail the process of transitioning VDC to PHV.
  • To discuss commonly used PHV modes and essential settings for home care.

Main Methods:

  • Literature review of current practices and available technologies for VDC home transition.
  • Analysis of ventilator modes and settings suitable for PHV in chronic respiratory failure.
  • Examination of readiness assessment criteria for home care.

Main Results:

  • Identified key factors for assessing VDC transition readiness.
  • Outlined strategies for selecting appropriate PHV and optimizing settings.
  • Described various PHV modes that promote synchronous breathing and adequate gas exchange.

Conclusions:

  • Successful home transition for VDC requires thorough assessment and careful ventilator management.
  • Understanding PHV capabilities and settings is crucial for supporting chronic respiratory failure at home.
  • This review provides a framework for clinicians managing VDC home care.

Keywords:
bronchopulmonary dysplasiachronic respiratory failurehome mechanical ventilationlong term ventilatory supportpediatricsportable ventilatorrespiratorytransition to home

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