Outcomes of Children Treated With Tracheostomy and Positive-Pressure Ventilation at Home
Autor: | Martin L. Bauer, Todd G. Nick, Dennis Z. Kuo, Gulnur Com, Claire V. Lenker, Christopher M. Makris, Maria Melguizo-Castro |
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Rok vydání: | 2012 |
Předmět: |
Lung Diseases
Male Pediatrics medicine.medical_specialty Home Care Services Hospital-Based Kaplan-Meier Estimate Primary care Congenital Abnormalities Positive-Pressure Respiration Tracheostomy Central Nervous System Diseases Humans Medicine Single institution Positive pressure ventilation Retrospective Studies business.industry Outcome measures Infant Retrospective cohort study Confidence interval Lung disease Child Preschool Chronic Disease Pediatrics Perinatology and Child Health Breathing Female Respiratory Insufficiency business |
Zdroj: | Clinical Pediatrics. 52:54-61 |
ISSN: | 1938-2707 0009-9228 |
DOI: | 10.1177/0009922812465943 |
Popis: | Background. Long-term outcomes for children who survive on tracheostomy and positive-pressure ventilation (TPPV) at home are not well known. Methods. A retrospective review of 20 years of clinical data at a single institution was performed. Outcome measures included 5-year survival, decannulation rate, and neurocognition. Results. A total of 91 children were categorized under neuromotor dysfunction (52%), chronic lung disease (29%), and congenital anomalies (20%). The 5-year survival rates for these categories were 89% (95% confidence interval [CI] = 80%-99%), 76% (95% CI = 57%-100%), and 94% (95% CI = 83%-100%), respectively. Overall, the 5-year decannulation rate was 25% (95% CI = 14%-35%), with children with chronic lung disease having the highest rate (51%). It was found that 14% were extremely delayed in neurocognition. Conclusion. Most children on TPPV at home survive beyond 5 years, and a significant number are decannulated. Primary care physicians and communities should be prepared to accommodate the increasing number of children on TPPV at home. |
Databáze: | OpenAIRE |
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