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Ventilator-associated respiratory infections in children on home invasive mechanical ventilation

Cristina Tomatis-Souverbielle1, Elizabeth Lyman2, Terace Thomas3

  • 1Division of Infectious Diseases, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA.

Pediatric Pulmonology
|June 5, 2024
PubMed

Insights

Ventilator-associated respiratory tract infections (VARTI) are common in children needing home ventilation. This review covers VARTI diagnosis, management, and challenges in this population.

Area of Science:

  • Pediatric critical care medicine
  • Infectious disease epidemiology
  • Respiratory medicine

Background:

  • Ventilator-associated respiratory tract infections (VARTI) are a significant concern in children with chronic respiratory failure requiring home mechanical ventilation.
  • These infections contribute to increased hospitalizations and healthcare burden in pediatric patients.

Purpose of the Study:

  • To provide a comprehensive overview of home-based VARTI in children with chronic respiratory failure.
  • To delineate key clinical features, diagnostic strategies, and management guidelines for VARTI in this specific patient group.
  • To identify and discuss the inherent challenges associated with diagnosing and managing VARTI in the home setting.

Main Methods:

  • Systematic literature review of studies focusing on VARTI in pediatric patients on home ventilation.
  • Analysis of clinical case reports and cohort studies to identify common presentations and outcomes.
  • Synthesis of current guidelines and expert opinions on diagnosis and treatment.

Main Results:

  • VARTI presents with diverse clinical manifestations in children requiring home ventilation, often mimicking underlying respiratory conditions.
  • Diagnostic approaches require careful consideration of clinical signs, microbiological data, and patient-specific factors.
  • Management strategies involve prompt antimicrobial therapy, optimizing ventilation settings, and addressing potential complications.

Conclusions:

  • Effective management of home VARTI in children necessitates a multidisciplinary approach, integrating expertise in pulmonology, infectious diseases, and home healthcare.
  • Addressing diagnostic and management challenges is crucial for improving patient outcomes and reducing hospital readmissions.
  • Further research is warranted to establish standardized protocols for VARTI prevention and treatment in this vulnerable pediatric population.

Keywords:
childrenhome‐ventilationtracheitisventilator‐associated pneumonia

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