Invasive and non-invasive long-term mechanical ventilation in Italian children

F. Racca, M. Bonati, L. del Sorbo, G. Berta, M. Sequi, E. C. Capello, A. Wolfler, I. Salvo, E. Bignamini, G. Ottonello, R. Cutrera, P. Biban, F. Benini, V. M. Ranieri

Research output: Contribution to journalArticle

Abstract

Background. To date, few studies have been published regarding the number of children in Italy who require long-term mechanical ventilation (LTV) and their underlying diagnoses, ventilatory needs and hospital discharge rate. Methods. A preliminary national postal survey was conducted and identified 535 children from 57 centers. Detailed data were then obtained for 378 children from 30 centers. Results. The estimated prevalence in Italy of this population was 4.3/100000. The majority of children (72.2%) were followed in pediatric units. The primary physicians who cared for these patients were either pediatric intensivists or pediatric pulmonologists. Neurological patients (78.2% of cases) represented the principal disorder category. 57.2% of the patients were non-invasively ventilated, with a nasal mask being the most common interface (85% of cases). The presence of clinical symptoms that were associated with abnormal findings on diagnostic testing was the primary indication for ventilatory support, whereas weaning failure was the primary indication for tracheotomy. Invasive ventilation was significantly related to younger age, longer daily hours on ventilation and cerebral palsy. Ventilatory modes with guaranteed minimal tidal volume were more often used in patients with tracheotomy. Despite their age, illness severity and need for technological care, 98% of the study population were successfully home discharged. Conclusions. Managing pediatric home LTV requires tremendous effort on the part of the patient's family and places a significant strain on community financial resources. In particular, neurological patients require more health care than patients in other categories. To further improve the quality of care for these patients, it is essential to establish a dedicated national database.

Original languageEnglish
Pages (from-to)892-901
Number of pages10
JournalMinerva Anestesiologica
Volume77
Issue number9
Publication statusPublished - Sep 2011

Fingerprint

Artificial Respiration
Pediatrics
Tracheotomy
Italy
Ventilation
Quality of Health Care
Tidal Volume
Cerebral Palsy
Masks
Weaning
Nose
Population
Databases
Delivery of Health Care
Physicians

Keywords

  • Artificial respiration
  • Child
  • Respiratory insufficiency

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Racca, F., Bonati, M., del Sorbo, L., Berta, G., Sequi, M., Capello, E. C., ... Ranieri, V. M. (2011). Invasive and non-invasive long-term mechanical ventilation in Italian children. Minerva Anestesiologica, 77(9), 892-901.

Invasive and non-invasive long-term mechanical ventilation in Italian children. / Racca, F.; Bonati, M.; del Sorbo, L.; Berta, G.; Sequi, M.; Capello, E. C.; Wolfler, A.; Salvo, I.; Bignamini, E.; Ottonello, G.; Cutrera, R.; Biban, P.; Benini, F.; Ranieri, V. M.

In: Minerva Anestesiologica, Vol. 77, No. 9, 09.2011, p. 892-901.

Research output: Contribution to journalArticle

Racca, F, Bonati, M, del Sorbo, L, Berta, G, Sequi, M, Capello, EC, Wolfler, A, Salvo, I, Bignamini, E, Ottonello, G, Cutrera, R, Biban, P, Benini, F & Ranieri, VM 2011, 'Invasive and non-invasive long-term mechanical ventilation in Italian children', Minerva Anestesiologica, vol. 77, no. 9, pp. 892-901.
Racca F, Bonati M, del Sorbo L, Berta G, Sequi M, Capello EC et al. Invasive and non-invasive long-term mechanical ventilation in Italian children. Minerva Anestesiologica. 2011 Sep;77(9):892-901.
Racca, F. ; Bonati, M. ; del Sorbo, L. ; Berta, G. ; Sequi, M. ; Capello, E. C. ; Wolfler, A. ; Salvo, I. ; Bignamini, E. ; Ottonello, G. ; Cutrera, R. ; Biban, P. ; Benini, F. ; Ranieri, V. M. / Invasive and non-invasive long-term mechanical ventilation in Italian children. In: Minerva Anestesiologica. 2011 ; Vol. 77, No. 9. pp. 892-901.
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abstract = "Background. To date, few studies have been published regarding the number of children in Italy who require long-term mechanical ventilation (LTV) and their underlying diagnoses, ventilatory needs and hospital discharge rate. Methods. A preliminary national postal survey was conducted and identified 535 children from 57 centers. Detailed data were then obtained for 378 children from 30 centers. Results. The estimated prevalence in Italy of this population was 4.3/100000. The majority of children (72.2{\%}) were followed in pediatric units. The primary physicians who cared for these patients were either pediatric intensivists or pediatric pulmonologists. Neurological patients (78.2{\%} of cases) represented the principal disorder category. 57.2{\%} of the patients were non-invasively ventilated, with a nasal mask being the most common interface (85{\%} of cases). The presence of clinical symptoms that were associated with abnormal findings on diagnostic testing was the primary indication for ventilatory support, whereas weaning failure was the primary indication for tracheotomy. Invasive ventilation was significantly related to younger age, longer daily hours on ventilation and cerebral palsy. Ventilatory modes with guaranteed minimal tidal volume were more often used in patients with tracheotomy. Despite their age, illness severity and need for technological care, 98{\%} of the study population were successfully home discharged. Conclusions. Managing pediatric home LTV requires tremendous effort on the part of the patient's family and places a significant strain on community financial resources. In particular, neurological patients require more health care than patients in other categories. To further improve the quality of care for these patients, it is essential to establish a dedicated national database.",
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AU - Capello, E. C.

AU - Wolfler, A.

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