Paediatric home ventilatory support: The Auckland experience

E. A. Edwards, K. Hsiao, G. M. Nixon

Research output: Contribution to journalReview ArticleResearchpeer-review

45 Citations (Scopus)

Abstract

Objectives: To examine the trend over time, describe the disease categories treated, intervention success and outcomes of the children treated at home with continuous positive airway pressure (CPAP), non-invasive ventilation (NIV) and ventilation via tracheostomy (invasive ventilatory support, IVS) by the Respiratory Service at the Starship Children's Hospital in Auckland. Methods: A retrospective review was undertaken of the Respiratory Service records from November 1991 to February 2004. Results: Home CPAP, NIV or IVS was initiated in 160 children (89 boys, median age 6 years) in the study period. Sixty-nine (46 boys) remain on support and are still actively managed by the Starship Respiratory Service, of whom 46% live outside the Greater Auckland Region. Despite 42% of children being less than 5 years of age at initiation of therapy, institution of support failed in only 11%. The majority received treatment by non-invasive mask interface (68% (n = 108) CPAP, 29% (n = 47) NIV), with only 3% (n = 5) supported via tracheostomy. The numbers and complexity of support rose over the 12 years. Respiratory support was discontinued in 57% of cases, after a median of 12.5 months (range 3-52 months); in two-thirds, support was no longer required due to an improvement in the medical condition. The most common indication for support in current patients is respiratory parenchymal or airway disease followed by neuromuscular disease. Obesity is not a common indication. Conclusion: This review documents the increasing trend in children receiving respiratory support at home. Future planning and resources are needed to address this growing need.

Original languageEnglish
Pages (from-to)652-658
Number of pages7
JournalJournal of Paediatrics and Child Health
Volume41
Issue number12
DOIs
Publication statusPublished - 1 Dec 2005
Externally publishedYes

Keywords

  • BiPAP
  • CPAP
  • Home ventilation
  • Non-invasive ventilation
  • Tracheostomy

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