Article Text

HOME DISCHARGE AND MONITORING PROGRAM FOR HOME MECHANICALLY VENTILATED CHILDREN IN ITALY
  1. F Racca1,
  2. M Bonati2,
  3. G Ottonello3,
  4. G Berta1,
  5. M Pavone4,
  6. F Morandi6,
  7. A Wolfler7,
  8. I Tardivo8,
  9. R Testa5,
  10. M Sequi2,
  11. A Costantino9,
  12. L DelSorbo1,
  13. E Recchia1,
  14. M Maspoli9,
  15. E Bignamini8,
  16. I Salvo7,
  17. V M Ranieri1
  1. 1Anestesia e Rianimazione, Universita’ di Torino, Torino, Italy
  2. 2Istituto di Ricerche Farmacologiche Mario Negri Milano, Milan, Italy
  3. 3Anestesia e Rianimazione, Istituto G. Gaslini Genova, Genova, Italy
  4. 4Pneumologia, Ospedale Bambin Gesu’ Roma, Rome, Italy
  5. 5Anestesia e Rianimazione, Ospedale Santobono Napoli, Napoli, Italy
  6. 6Pediatria, Ospedale Sacra Famiglia Erba, Erba, Italy
  7. 7Anestesia e Rianimazione, Ospedale Buzzi Milano, Milan, Italy
  8. 8Pneumologia, OIRM Torino, Torino, Italy
  9. 9Assessorato Alla Sanita’ Regione Piemonte, Piemonte, Italy
  10. 10Ospedale Civile Maggiore Verona, Verona, Italy

Abstract

Introduction The psychological and developmental advantages of home mechanical ventilation (HMV) for children with chronic respiratory failure are well recognized. Home care of HMV children should follow a monitoring program. The aim of the present study was to assess the modality of home discharge and follow-up for HMV children in Italy.

Methods Surveys were sent by mail to all centers thought to be involved in pediatric HMV. The study included all patients aged less than 18 years on HMV on January 1, 2007.

Three hundred children (mean age: 8.5+5.5 SD) requiring HMV were identified from 21 centers. Most frequent indication for LTV was the diagnosis of neuromuscular disease (n = 132). 93% of HMV children were involved in an inpatient ventilator training program. 75% of children received pulse oximetry monitoring at home.

The majority of children (98%) had a regular monitoring program (36% of patients during planned hospitalization, 30% during outpatient visits, 29% with both modalities, 5% only at home). During routine follow-up nocturnal pulse oximetry and polysomnography were recorded in 38% and 49% of patients, respectively. Overnight carbon dioxide monitoring was carried out in 24% of children. Arterial and capillary blood gases were analyzed in 39% and 18% of patients respectively. Daytime pulse oximetry and daytime carbon dioxide non-invasive monitoring were recorded in 29% and 13% of children respectively.

Conclusions The majority of HMV children in Italy undergo a regular follow-up schedule as part of a planned home discharge program.

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