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Changes in UK paediatric long-term ventilation practice over 10 years
  1. Nicki Barker1,
  2. Aditi Sinha2,
  3. Catherine Jesson1,
  4. Tahera Doctor3,
  5. Omendra Narayan2,
  6. Heather E Elphick1
  1. 1Respiratory Medicine, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
  2. 2Respiratory Medicine, Royal Manchester Children's Hospital, Manchester, UK
  3. 3Respiratory Medicine, Evelina London Children's Hospital, London, UK
  1. Correspondence to Dr Heather E Elphick, Respiratory Medicine, Sheffield Children's Hospital NHS Foundation Trust, Sheffield S10 2TH, UK; h.elphick{at}nhs.net

Abstract

Objectives To provide up-to-date information on the use of long-term ventilation (LTV) in the UK paediatric population and to compare the results with data collected 10 and 20 years previously.

Design A single timepoint census completed by LTV centres in the UK, carried out via an online survey.

Setting and patients All patients attending paediatric LTV services in the UK.

Results Data were collected from 25 LTV centres in the UK. The total study population was 2383 children and young people, representing a 2.5-fold increase in the last 10 years. The median age was 9 years (range 0–20 years). Notable changes since 2008 were an increase in the proportion of children with central hypoventilation syndrome using mask ventilation, an increase in overall numbers of children with spinal muscular atrophy (SMA) type 1, chronic lung disease of prematurity and cerebral palsy being ventilated, and a 4.2-fold increase in children using LTV for airway obstruction. The use of 24-hour ventilation, negative pressure ventilation and tracheostomy as an interface had declined. 115 children had received a disease-modifying drug. The use of ataluren and Myozyme did not influence the decision to treat with LTV, but in 35% of the children with SMA type 1 treated with nusinersin, the clinician stated that the use of this drug had or may have influenced their decision to initiate LTV.

Conclusion The results support the need for national database for children and young people using LTV at home to inform future recommendations and assist in resource allocation planning.

  • Paediatrics
  • Respiratory Medicine

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Twitter @nickiphysio

  • Contributors NB contributed to the conception and design of the work, the acquisition and interpretation of data and critical revision of the manuscript for important intellectual content. AS contributed to the data acquisition and drafting of the manuscript. CJ contributed to the data analysis and critical revision of the manuscript for important intellectual content. TD contributed to the data acquisition and critical revision of the manuscript for important intellectual content. ON contributed to the conception and design of the work, the interpretation of data and critical revision of the manuscript for important intellectual content. HEE contributed to the conception and design of the work, the analysis and interpretation of data, drafted the manuscript and acts as guarantor. All authors approved the final version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.