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儿童家庭机械通风的指示:四十年来的变化
Laura Verweij van den Oudenrijn1, Michael Gaytant2, Lieke Arts3
1Pediatric Intensive Care Unit and Center of Home Mechanical Ventilation, Wilhelmina Children's Hospital, University Medical Center Utrecht, 3508 AB, Utrecht, 85090, The Netherlands. l.verwey@umcutrecht.nl.
European journal of pediatrics
|October 28, 2025
概括
儿童的家庭机械通风 (HMV) 仍然稳定,但年轻患者和非侵入性通风 (NIV) 越来越多地使用. 随着时间的推移,HMV的原因也发生了变化.
科学领域:
- 儿科肺病学 儿科肺病学
- 呼吸系统医学 呼吸系统医学
- 医疗技术 医疗技术 医学技术
背景情况:
- 家庭机械通风 (HMV) 已经使用了40多年.
- 神经肌肉疾病是儿科HMV的主要适应症.
- 最近的趋势显示,小孩越来越多地使用HMV.
研究的目的:
- 评估需要HMV的儿童的人口统计数据.
- 分析随着时间的推移,指示和通风支类型的变化.
- 评估1979-2023年荷兰儿科HMV的发展趋势.
主要方法:
- 回顾性单中心队列研究.
- 从潜在数据库和医疗记录中收集的数据.
- 在1979年至2023年期间,对544名19岁以下儿童进行了HMV启动的分析.
主要成果:
- 开始HMV的儿童数量在2017年后稳定.
- 由于外科手术后或感染等意外原因,近40%的患者开始使用HMV.
- 在HMV中,5岁以下儿童的比例显著增加,特别是在非侵入性通风系统 (NIV) 中.
- 神经肌肉疾病 (56%) 和遗传综合征 (16%) 是常见的原因,但其他疾病在21世纪增加.
结论:
- 儿科HMV数量稳定,但患者人口统计和呼吸衰竭的原因已经演变.
- 非侵入性通风 (NIV) 现在是儿童启动HMV的主要模式.
- 在年幼的儿童中显著增加,特别是那些使用NIV的儿童,需要HMV.
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