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Home Ventilatory Assistance in Chilean Children: 12 Years' Experience
P. Bertrand
, E. Fehlmann, M. Lizama, N. Holmgren, M. Silva, I. Sánchez
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bertrand@med.puc.cl
Correspondence. Dr. P. Bertrand. Departamento de Pediatría. Pontificia Universidad Católica de Chile. Lira, 85, 5.o. Casilla 114-D. Santiago. Chile
Correspondence. Dr. P. Bertrand. Departamento de Pediatría. Pontificia Universidad Católica de Chile. Lira, 85, 5.o. Casilla 114-D. Santiago. Chile
Sección de Respiratorio Pediátrico, Departamento de Pediatría, Pontificia Universidad Católica de Chile, Santiago, Chile
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Holmgren, M. Silva, I. Sánchez" "autores" => array:6 [ 0 => array:5 [ "preGrado" => "Dr." "nombre" => "P." "apellidos" => "Bertrand" "email" => array:1 [ 0 => "bertrand@med.puc.cl" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Fehlmann" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Lizama" ] 3 => array:2 [ "nombre" => "N." "apellidos" => "Holmgren" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Silva" ] 5 => array:2 [ "nombre" => "I." "apellidos" => "Sánchez" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Sección de Respiratorio Pediátrico, Departamento de Pediatría, Pontificia Universidad Católica de Chile, Santiago, Chile" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence. Dr. P. Bertrand. Departamento de Pediatría. Pontificia Universidad Católica de Chile. Lira, 85, 5.o. Casilla 114-D. Santiago. Chile" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-04-12" "fechaAceptado" => "2005-10-20" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154305" "palabras" => array:5 [ 0 => "Mechanical ventilation" 1 => "Assisted ventilation" 2 => "Invasive ventilation" 3 => "Chronic respiratory failure" 4 => "Children" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154304" "palabras" => array:5 [ 0 => "Ventilación mecánica" 1 => "Ventilación no invasiva" 2 => "Ventilación invasiva" 3 => "Insuficiencia respiratoria crónica" 4 => "Niños" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Home ventilatory support systems are a treatment option for patients with severe chronic respiratory failure. The objective of the present study was to characterize the children admitted to a home ventilatory assistance program.</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p class="elsevierStyleSimplePara elsevierViewall">The home ventilation program was created by our hospital to coordinate professional and technological support for chronic ventilator-dependent children. We revised and updated information on patient characteristics, type of assisted ventilation, respiratory morbidity, and equipment failures between 1993 and 2004.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Follow-up of 35 children (18 male) was carried out by our hospital staff. Median age upon admission to the program was 12 months (range, 5 months to 14 years). Median length of time in the program was 21 months and we were able to wean 40% of patients from ventilators. Six patients died. The main indications for assisted ventilation were neuromuscular disease (12 cases), airway alteration (11 cases), cardiopulmonary disease (7 cases), and hypoventilation syndrome (5 cases). The types of assisted ventilation used were continuous positive airway pressure (in 17 cases), bilevel positive pressure (in 8 cases), and synchronized intermittent mandatory ventilation (in 10 cases). Invasive ventilation via a tracheostomy was used in 26 cases. The use of noninvasive ventilation increased in the last 4 years. Respiratory morbidity (pneumonia and bacterial tracheitis) was the most frequent cause of hospitalization and the annual rate of such episodes was 1.6 per child. The annual rate of hospitalization due to equipment failures was 0.1 per child.</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p class="elsevierStyleSimplePara elsevierViewall">The program provides safe and necessary home ventilatory assistance for children with severe chronic respiratory failure. The professional support that home hospitalization offers had a positive effect on outcome in these children. It is important to take our experience into account in creating a Chilean national home ventilatory assistance program.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Los sistemas de apoyo ventilatorio domiciliario son una alternativa para el tratamiento de los pacientes con insuficiencia respiratoria crónica grave. El objetivo del presente estudio ha sido caracterizar a los niños ingresados en el Servicio de Asistencia Ventilatoria en Domicilio (SAVED).</p> <span class="elsevierStyleSectionTitle">Patientes y método</span><p class="elsevierStyleSimplePara elsevierViewall">El SAVED es un programa de nuestro hospital que coordina el apoyo profesional y tecnológico para niños con dependencia de asistencia ventilatoria (AV) crónica. Se revisaron y actualizaron datos demográficos, tipo de AV, morbilidad respiratoria y fallos de equipo entre 1993 y 2004.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se realizó seguimiento en nuestro centro a 35 niños (varones: 18). La mediana de edad al entrar en el programa fue de 12 meses (rango: 5 meses a 14 años). El tiempo de permanencia fue de 21 meses y la retirada del soporte se logró en el 40% del total. Fallecieron 6 pacientes. Las principales indicaciones de AV fueron: enfermedad neuromuscular en 12 casos, alteración de la vía aérea en 11, enfermedad cardiopulmonar en 7 y síndrome de hipoventilación en 5. Los tipos de AV utilizados fueron presión positiva continua de la vía aérea en 17 casos, presión positiva en 2 niveles (BiPAP) en 8 y ventilación mecánica intermitente sincronizada en 10. Se administró ventilación invasiva a 26 pacientes a través de traqueotomía. En los últimos 4 años se produjo un aumento de la utilización de la ventilación no invasiva. La morbilidad respiratoria (neumonía y traqueítis bacteriana) fue la causa más frecuente de hospitalización y alcanzó 1,6 evento/niño/año. Los fallos de sistema fueron causa de hospitalización en 0,1 evento/niño/año.</p> <span class="elsevierStyleSectionTitle">Conclusión</span><p class="elsevierStyleSimplePara elsevierViewall">El SAVED es un programa seguro y necesario para niños con insuficiencia respiratoria crónica de carácter grave. El apoyo profesional que proporciona la hospitalización domiciliaria ha beneficiado la evolución de estos niños. Es importante considerar esta experiencia para la formación de un programa nacional de AV domiciliaria.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:22 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Home treatment for chronic respiratory failure in children: a prospective study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B Fauroux" 1 => "A Sardet" 2 => "D Foret" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Respir J." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 2 | 7 |
| 2024 October | 26 | 15 | 41 |
| 2024 September | 37 | 18 | 55 |
| 2024 August | 44 | 46 | 90 |
| 2024 July | 27 | 30 | 57 |
| 2024 June | 29 | 22 | 51 |
| 2024 May | 30 | 23 | 53 |
| 2024 April | 16 | 19 | 35 |
| 2024 March | 19 | 18 | 37 |
| 2024 February | 20 | 22 | 42 |
| 2023 March | 4 | 3 | 7 |
| 2023 February | 14 | 18 | 32 |
| 2023 January | 16 | 23 | 39 |
| 2022 December | 17 | 25 | 42 |
| 2022 November | 15 | 19 | 34 |
| 2022 October | 20 | 28 | 48 |
| 2022 September | 10 | 16 | 26 |
| 2022 August | 17 | 24 | 41 |
| 2022 July | 15 | 36 | 51 |
| 2022 June | 17 | 33 | 50 |
| 2022 May | 13 | 26 | 39 |
| 2022 April | 11 | 25 | 36 |
| 2022 March | 19 | 31 | 50 |
| 2022 February | 16 | 27 | 43 |
| 2022 January | 17 | 34 | 51 |
| 2021 December | 16 | 42 | 58 |
| 2021 November | 18 | 49 | 67 |
| 2021 October | 17 | 53 | 70 |
| 2021 September | 15 | 50 | 65 |
| 2021 August | 7 | 28 | 35 |
| 2021 July | 14 | 29 | 43 |
| 2021 June | 9 | 34 | 43 |
| 2021 May | 12 | 21 | 33 |
| 2021 April | 21 | 65 | 86 |
| 2021 March | 17 | 17 | 34 |
| 2021 February | 10 | 17 | 27 |
| 2021 January | 4 | 12 | 16 |
| 2020 December | 13 | 12 | 25 |
| 2020 November | 6 | 12 | 18 |
| 2020 October | 10 | 7 | 17 |
| 2020 September | 7 | 5 | 12 |
| 2020 August | 8 | 12 | 20 |
| 2020 July | 10 | 14 | 24 |
| 2020 June | 8 | 5 | 13 |
| 2020 May | 13 | 16 | 29 |
| 2020 April | 13 | 13 | 26 |
| 2020 March | 14 | 15 | 29 |
| 2020 February | 15 | 20 | 35 |
| 2020 January | 12 | 22 | 34 |
| 2019 December | 13 | 25 | 38 |
| 2019 November | 13 | 18 | 31 |
| 2019 October | 3 | 6 | 9 |
| 2019 September | 7 | 18 | 25 |
| 2019 August | 9 | 5 | 14 |
| 2019 July | 16 | 13 | 29 |
| 2019 June | 5 | 8 | 13 |
| 2019 May | 10 | 17 | 27 |
| 2019 April | 13 | 22 | 35 |
| 2019 March | 5 | 18 | 23 |
| 2019 February | 3 | 10 | 13 |
| 2019 January | 2 | 10 | 12 |
| 2018 December | 4 | 17 | 21 |
| 2018 November | 9 | 6 | 15 |
| 2018 October | 15 | 15 | 30 |
| 2018 September | 7 | 12 | 19 |
| 2018 May | 6 | 1 | 7 |
| 2018 April | 4 | 5 | 9 |
| 2018 March | 3 | 3 | 6 |
| 2018 February | 4 | 7 | 11 |
| 2018 January | 3 | 9 | 12 |
| 2017 December | 3 | 11 | 14 |
| 2017 November | 5 | 4 | 9 |
| 2017 October | 3 | 7 | 10 |
| 2017 September | 6 | 6 | 12 |
| 2017 August | 7 | 7 | 14 |
| 2017 July | 1 | 5 | 6 |
| 2017 June | 7 | 17 | 24 |
| 2017 May | 5 | 6 | 11 |
| 2017 April | 2 | 4 | 6 |
| 2017 March | 4 | 8 | 12 |
| 2017 January | 2 | 2 | 4 |
| 2016 December | 14 | 10 | 24 |
| 2016 November | 13 | 10 | 23 |
| 2016 October | 24 | 12 | 36 |
| 2016 September | 4 | 3 | 7 |
| 2016 August | 5 | 3 | 8 |
| 2016 July | 8 | 3 | 11 |
| 2016 June | 1 | 0 | 1 |
| 2016 May | 2 | 0 | 2 |
| 2016 April | 4 | 0 | 4 |
| 2016 March | 3 | 0 | 3 |
| 2016 February | 4 | 0 | 4 |
| 2016 January | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 November | 1 | 0 | 1 |
| 2015 October | 51 | 5 | 56 |
| 2015 September | 55 | 9 | 64 |
| 2015 August | 47 | 8 | 55 |
| 2015 July | 72 | 12 | 84 |
| 2015 June | 41 | 6 | 47 |
| 2015 May | 48 | 10 | 58 |
| 2015 April | 40 | 11 | 51 |
| 2015 March | 42 | 5 | 47 |
| 2015 February | 39 | 5 | 44 |
| 2015 January | 56 | 6 | 62 |
| 2014 December | 43 | 9 | 52 |
| 2014 November | 45 | 5 | 50 |
| 2014 October | 41 | 16 | 57 |
| 2014 September | 44 | 10 | 54 |
| 2014 August | 41 | 10 | 51 |
| 2014 July | 39 | 7 | 46 |
| 2014 June | 49 | 12 | 61 |
| 2014 May | 39 | 12 | 51 |
| 2014 April | 87 | 7 | 94 |
| 2014 March | 61 | 15 | 76 |
| 2014 February | 55 | 9 | 64 |
| 2014 January | 47 | 6 | 53 |
| 2013 December | 44 | 15 | 59 |
| 2013 November | 35 | 4 | 39 |
| 2013 October | 43 | 13 | 56 |
| 2013 September | 36 | 9 | 45 |
| 2013 August | 38 | 7 | 45 |
| 2013 July | 53 | 10 | 63 |
| 2013 June | 34 | 6 | 40 |
| 2013 May | 28 | 2 | 30 |
| 2013 April | 24 | 6 | 30 |
| 2013 March | 5 | 1 | 6 |
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