Evaluation of Emergency Service Applications of Home Mechanical Ventilator Dependent Children
PDF
Cite
Share
Request
Research Article
P: 49-54
August 2020

Evaluation of Emergency Service Applications of Home Mechanical Ventilator Dependent Children

J Pediatr Emerg Intensive Care Med 2020;7(2):49-54
1. Sağlık Bilimleri Üniversitesi Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji Eğitim ve Araştırma Hastanesi, Çocuk Acil Kliniği, Ankara, Türkiye
2. Ankara Üniversitesi Tıp Fakültesi, Çocuk Yoğun Bakım Bilim Dalı, Ankara, Türkiye
3. Ankara Üniversitesi Tıp Fakültesi, Çocuk Acil Bilim Dalı, Ankara, Türkiye
No information available.
No information available
Received Date: 15.02.2019
Accepted Date: 10.05.2019
Publish Date: 11.06.2020
PDF
Cite
Share
Request

ABSTRACT

Introduction:

There has been an increase in the number of patients using home mechanical ventilator for suffering from chronic respiratory failure, due to the recent technological developments and increasing experience. The aim of this study is to determine the most common reasons for emergency admissions and treatments applied, and the most frequent reasons for hospitalization.

Methods:

Mechanical ventilator dependent children, who were admitted to the Ankara University Faculty of Medicine and Health Sciences University Ankara Pediatric Health and Disease Hematology Oncology Training and Research Hospital Emergency Services between October 2014 and October 2015, were evaluated retrospectively.

Results:

Seventy-one patients were included in the study. The median age was 42 months and 40 of them (56.3%) were male. The mean duration of mechanical ventilation was 15.0 months. The most common complaint for being admitted to the emergency department was decreased oxygen saturation (14.1%); 17 patients (23.9%) were admitted to the emergency department due to non-emergent reasons. The median number of applications within one year was 3. Twenty-six patients (36.6%) were hospitalized. The most common reason for hospitalization was pneumonia (26.8%). When the resource usage was evaluated according to the five-step triage system, 97.1% of the patients used 2 or more resources in the emergency department.

Conclusion:

It was found that emergency department admissions and hospital resource usage were higher in the children who were followed with home mechanical ventilator. The reason for the increased number of emergency room admissions may be due to applications for non-urgent reasons.

Keywords:
Home mechanical ventilator, child, pediatric emergency, gastrostomy

References

1
Graham RJ, Fleegler EW, Robinson WM. Chronic ventilator need in the community: a 2005 pediatric census of Massachusetts. Pediatrics. 2007;119:e1280-7.
2
Ottonello G, Ferrari I, Pirroddi IM, Diana MC, Villa G, et al. Home mechanical ventilation in children: retrospective survey of a pediatric population. Pediatr Int. 2007;49:801-5.
3
Oktem S, Ersu R, Uyan ZS, Cakir E, Karakoc F, et al. Home ventilation for children with chronic respiratory failure in Istanbul. Respiration. 2008;76:76-81.
4
Kamm M, Burger R, Rimensberger P, Knoblauch A, Hammer J. Survey of children supported by long-term mechanical ventilation in Switzerland. Swiss Med Wkly. 2001;131:261-6.
5
Simonds AK. Home ventilation. Eur Respir J. 2003;47:38s-46s.
6
Fauroux B, Boffa C, Desguerre I, Estournet B, Trang H. Long-term noninvasive mechanical ventilation for children at home: a national survey. Pediatr Pulmonol. 2003;35:119-25.
7
Make BJ, Hill NS, Goldberg AI, Bach JR, Criner GJ, et al. Mechanical ventilation beyond the intensive care unit. Report of a consensus conference of the American College of Chest Physicians. Chest. 1998;113:289S-344S.
8
King AC. Long-term home mechanical ventilation in the United States. Respir Care. 2012;57:921-30; discussion 30-2.
9
Reiter K, Pernath N, Pagel P, Hiedi S, Hoffmann F, et al. Risk factors for morbidity and mortality in pediatric home mechanical ventilation. Clin Pediatr (Phila). 2011;50:237-43.
10
Mesman GR, Kuo DZ, Carroll JL, Ward WL. The impact of technology dependence on children and their families. J Pediatr Health Care. 2013;27:451-9.
11
Didişen NA, Çevik Özdemir HN, Keskin E. Teknolojiye Bağımlı Çocuk ve Evde Bakım. J Pediatr Emerg Intensive Care Med. 2017:123-9.
12
Wang KW, Barnard A. Technology-dependent children and their families: a review. J Adv Nurs. 2004;45:36-46.
13
Kuhlthau KA, Bloom S, Van Cleave J, Knapp AA, Romm D, et al. Evidence for family-centered care for children with special health care needs: a systematic review. Acad Pediatr. 2011;11:136-43.
14
Hudson SM. Hospital readmissions and repeat emergency department visits among children with medical complexity: an integrative review. J Pediatr Nurs. 2013;28:316-39.
15
Kuruoğlu RŞİ, Karasoy H.; Erdem S. Nöromüsküler hastalıklar tanı ve tedavi rehberi. Available at: https://www.noroloji.org.tr/TNDData/Uploads/files/NÖROMÜSKÜLER.pdf. Accessed.
16
Gilboy NT, P.;Travers,D.A.;Rosenau,A.M.;Eitel,D.R. Emergency Severity Index, Version 4: Implementation Handbook. 2005.
17
Amin R, Sayal P, Syed F, Chaves A, Moraes TJ, et al. Pediatric long-term home mechanical ventilation: twenty years of follow-up from one Canadian center. Pediatr Pulmonol. 2014;49:816-24.
18
Preutthipan A. Home Mechanical Ventilation in Children. Indian J Pediatr. 2015;82:852-9.
19
Sovtic A, Minic P, Vukcevic M, Markovic-Sovtic G, Rodic M, et al. Home mechanical ventilation in children is feasible in developing countries. Pediatr Int. 2012;54:676-81.
20
Gowans M, Keenan HT, Bratton SL. The population prevalence of children receiving invasive home ventilation in Utah. Pediatr Pulmonol. 2007;42:231-6.
21
Bertrand P, Fehlmann E, Lizama M, Holmgren N, Silva M, et al. [Home ventilatory assistance in Chilean children: 12 years' experience]. Arch Bronconeumol. 2006;42:165-70.
22
Racca F, Berta G, Sequi M, Bignamini E, Capello E, et al. Long-term home ventilation of children in Italy: a national survey. Pediatr Pulmonol. 2011;46:566-72.
23
Tzeng AC, Bach JR. Prevention of pulmonary morbidity for patients with neuromuscular disease. Chest. 2000;118:1390-6.
24
Amirnovin R, Aghamohammadi S, Riley C, Woo MS, Del Castillo S. Analysis of a Pediatric Home Mechanical Ventilator Population. Respir Care. 2018;63:558-64.
25
Hsia SH, Lin JJ, Huang IA, Wu CT. Outcome of long-term mechanical ventilation support in children. Pediatr Neonatol. 2012;53:304-8.
26
Carr MM, Poje CP, Kingston L, Kielma D, Heard C. Complications in pediatric tracheostomies. Laryngoscope. 2001;111:1925-8.
27
Sherman JM, Davis S, Albamonte-Petrick S, Chatburn RL, Fitton C, et al. Care of the child with a chronic tracheostomy. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. Am J Respir Crit Care Med. 2000;161:297-308.
28
Epstein SK. Late complications of tracheostomy. Respir Care. 2005;50:542-9.
29
Goldenberg D, Ari EG, Golz A, Danino J, Netzer A, et al. Tracheotomy complications: a retrospective study of 1130 cases. Otolaryngol Head Neck Surg. 2000;123:495-500.
30
Neuman MI, Hall M, Gay JC, Blaschke AJ, Williams DJ, et al. Readmissions among children previously hospitalized with pneumonia. Pediatrics. 2014;134:100-9.
31
Okido AC, Pina JC, Lima RA. [Factors associated with involuntary hospital admissions in technology-dependent children]. Rev Esc Enferm USP. 2016;50:29-35.