Home care for chronic respiratory failure in children: 15 years experience.

摘要: Background: Advances in paediatric intensive care have reduced mortality but, unfortunately, one of the consequences is an increase number patients with chronic diseases. It generally agreed that home children requiring ventilatory support improves their outcomes and results cost saving for National Health Service. Methods: Since 1985, Children's Hospital Bambino Gesu Rome has developed a program care. The performed by committed Home Care Team (HHCT) which selects eligible trains families to treat child. During period January 1985 2001, 53 respiratory failure were included program. Of these, seven successively excluded six died our unit (ICU), while still lives ICU since 1997. obtained remaining 46 are reported. Results: The pathologies consisted disorders control related brain damage (26%), upper airways obstructive disease spinal muscular atrophy (22%), myopathies dystrophies (6.5%), bronchopulmonary dysplasia tracheomalacia central hypoventilation syndrome (4.3%) progressive congenital scoliosis (2.2%). these patients, 34 mechanically ventilated median stay was 109.5 days (range 54–214 days), 12 breathing spontaneously 90.5 days 61–134 days). We temporarily readmitted perform scheduled otolaryngological surgery, eight acute infections two deterioration neurological status due high pressure hydrocephalus placement ventriculoperitoneal shunt; 16 discharged back again. Two other ICU, at home. Conclusions: Thirty-seven alive four them improved condition so it possible remove tracheostomy tube. Our oldest patient now achieved 15 years mechanical ventilation home.