Related Experiment Video
Updated: Jul 1, 2025
Manufacture of a Multi-Purpose Low-Cost Animal Bench-Model for Teaching Tracheostomy
Published on: May 18, 2019
Autism and neurodevelopmental disability risks in children with tracheostomies and ventilators
Sarah A Sobotka1, Emma Lynch1, Chuanhong Liao2
1Section of Developmental and Behavioral Pediatrics, Department of Pediatrics, The University of Chicago, Chicago, Illinois, USA.
Insights
Children requiring invasive mechanical ventilation (IMV) at home after critical illness face high risks for autism spectrum disorder (ASD) and intellectual disability (ID). This study found 67% of such children showed signs of these developmental concerns.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Neonatology
Background:
- Infants surviving critical illness requiring postdischarge invasive mechanical ventilation (IMV) are at high risk for neurodevelopmental delays.
- Previous studies on extremely preterm infants show significant rates of intellectual disability (ID) and autism spectrum disorder (ASD).
- Neurodevelopmental outcomes in children with postdischarge IMV are not well-established.
Purpose of the Study:
- To determine the risk of neurodevelopmental disabilities, including ASD and ID, in children requiring IMV after hospital discharge.
- To assess cognitive, social, and communicative development in this vulnerable pediatric population.
Main Methods:
- A cohort of 18 children with postdischarge IMV were followed for one year.
- Neurodevelopmental assessments included the capute scales (CAT/CLAMS), PEDI-CAT, and MCHAT-R.
- Developmental and Behavioral Pediatricians evaluated for ASD and ID using DSM-V criteria and expert consensus.
Main Results:
- At one year post-discharge, the median age was 23 months.
- 83% of the children were survivors of prematurity.
- 67% of the children were highly suspicious for ASD and/or evolving ID, with median developmental quotients ranging from 49.5 to 66.5.
Conclusions:
- Children with at-home IMV exhibit a higher risk for ASD and ID compared to previous premature infant cohorts.
- This study highlights the need for closer monitoring and early intervention for this population.
- Larger studies with extended follow-up are required to confirm these findings.
Background/Objective:
Infants who survive prematurity and other critical illnesses and require continued invasive mechanical ventilation (IMV) postdischarge (at home) are at high risk of developmental delays and disabilities. Studies of extremely preterm cohorts (<28-week gestation) demonstrate rates of 25% for intellectual disability (ID) and 7% for autism spectrum disorder (ASD). Rates of ASD and ID in children with IMV are unknown. This study aimed to determine neurodevelopmental disability risk in a cohort of children with postdischarge IMV.
Design/Methods:
A consecutive series of children with IMV were assessed 1 month, 6 months, and 1 year after discharge. Cognitive, social, and communicative domains were assessed by a Developmental and Behavioral Pediatrician using (1) clinical adaptive test/clinical linguistic and auditory milestone scale (CAT/CLAMS) of the capute scales; (2) pediatric evaluation of disability inventory computer adaptive test (PEDI-CAT); and (3) modified checklist for autism in toddlers, revised (MCHAT-R). Red flag signs and symptoms of ASD using DSM-V criteria were noted. Longitudinal testing was reviewed. Expert consensus impressions of evolving ASD and/or ID were determined.
Results:
Eighteen children were followed for 1 year; at 1 year, the median age (range) was 23 (17-42) months. Children were 44% male, 33% non-Hispanic White, 39% non-Hispanic Black, and 28% Hispanic. Fifteen (83%) children were prematurity survivors. Median (range) developmental quotients (DQs): full-scale DQ 59 (11-86), CAT DQ 66.5 (8-96), and CLAMS DQ 49.5 (13-100). Twelve (67%) children were highly suspicious for ASD and/or evolving ID.
Conclusions/Significance:
This cohort of children with at-home IMV demonstrates a higher risk of ASD and ID than prior premature cohorts. Larger investigations with longer follow-up are needed.
More Related Videos
09:10Heterotopic and Orthotopic Tracheal Transplantation in Mice used as Models to Study the Development of Obliterative Airway Disease
Published on: January 20, 2010
04:43Endotracheal Intubation via Tracheotomy and Subsequent Thoracotomy in Rats for Non-Survival Applications
Published on: March 15, 2024
Related Concept Videos
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
01:23Oxygen Delivering System III: Tracheostomy and T-piece
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
01:22Trachea
Anatomical Features:
Location: About half of the trachea is situated in the neck, anterior to the esophagus, and extends from the larynx (at the level of...
01:28Tracheostomy: Procedure and Tubes
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
01:21Tracheostomy Decannulation
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
01:16Tracheostomy Care I: Pre-procedural Steps
Required Equipment
The equipment necessary for tracheostomy care includes: