Long-term home ventilation of children in Italy: A national survey
F. Racca MD
Department of Anesthesiology and Intensive Care Medicine, San Giovanni Battista-Molinette Hospital, University of Turin, Turin, Italy
Search for more papers by this authorG. Berta MD
Department of Anesthesiology and Intensive Care Medicine, San Giovanni Battista-Molinette Hospital, University of Turin, Turin, Italy
Search for more papers by this authorM. Sequi STAT D
Department of Public Health, Laboratory for Mother and Child Health, “Mario Negri” Pharmacological Research Institute, Milan, Italy
Search for more papers by this authorE. Bignamini MD
Pulmonology Unit, Regina Margherita University Children's Hospital, Turin, Italy
Search for more papers by this authorE. Capello MD
Department of Anesthesiology and Intensive Care Medicine, San Giovanni Battista-Molinette Hospital, University of Turin, Turin, Italy
Search for more papers by this authorR. Cutrera MD
Respiratory Unit, Bambino Gesu' Children's Research Hospital, Rome, Italy
Search for more papers by this authorG. Ottonello MD
Anesthesiology and Intensive Care Medicine Unit, G. Gaslini Institute, Genoa, Italy
Search for more papers by this authorV.M. Ranieri MD
Department of Anesthesiology and Intensive Care Medicine, San Giovanni Battista-Molinette Hospital, University of Turin, Turin, Italy
Search for more papers by this authorI. Salvo MD
Department of Anesthesiology and Intensive Care, Vittore Buzzi Children's Hospital, Milan, Italy
Search for more papers by this authorR. Testa
Intensive Care Unit, Santobono Hospital, Naples, Italy
Search for more papers by this authorA. Wolfler MD
Department of Anesthesiology and Intensive Care, Vittore Buzzi Children's Hospital, Milan, Italy
Search for more papers by this authorCorresponding Author
M. Bonati MD
Department of Public Health, Laboratory for Mother and Child Health, “Mario Negri” Pharmacological Research Institute, Milan, Italy
Head of Department of Public Health and of the Laboratory for Mother and Child Health “Mario Negri” Pharmacological Research Institute Via Giuseppe La Masa 19, 20156 Milan, Italy.Search for more papers by this authoron behalf of the “LTV Pediatric Italian Network”
“LTV Pediatric Italian Network”: Anna Costantino, Alessandria; Raffaella Pagni, Ancona; Anna Maria Miorelli, Arco; Paolo Castaldi, Cagliari; Mariano Cabras, Carbonia; Bruno Dengo, Castelfranco Veneto; Augusto Biasini, Cesena; Francesco Morandi, Erba; Carlo Minetti, Giancarlo Ottonello, Genova; Paolo Banfi, Maurizio Bonati, Edoardo Calderini, Edi Prandi, Ida Salvo, Marco Sequi, Andrea Wolfler, Marco Zucconi, Milano; Giuseppe Fiorentino, Antonio Maddalena, Raffaele Testa, Napoli; Grazia Crescimanno, Anna Guddo, Palermo; Livio Carnevale, Pavia; Andrea Vianello, Padova; Giancarlo Piccinini, Ravenna; Valter Bottari, Reggio Emilia; Maurizio Corbari, Renato Cutrera, Martino Pavone, Roma; Giacomo Berta, Elisabetta Bignamini, Elena Capello, Lorenzo Del Sorbo, Cesare Gregoretti, Maria Maspoli, Fabrizio Racca, Marco V. Ranieri, Torino; Antonio Peratoner, Udine; Monica Benedetti, Verona.
Search for more papers by this authorF. Racca MD
Department of Anesthesiology and Intensive Care Medicine, San Giovanni Battista-Molinette Hospital, University of Turin, Turin, Italy
Search for more papers by this authorG. Berta MD
Department of Anesthesiology and Intensive Care Medicine, San Giovanni Battista-Molinette Hospital, University of Turin, Turin, Italy
Search for more papers by this authorM. Sequi STAT D
Department of Public Health, Laboratory for Mother and Child Health, “Mario Negri” Pharmacological Research Institute, Milan, Italy
Search for more papers by this authorE. Bignamini MD
Pulmonology Unit, Regina Margherita University Children's Hospital, Turin, Italy
Search for more papers by this authorE. Capello MD
Department of Anesthesiology and Intensive Care Medicine, San Giovanni Battista-Molinette Hospital, University of Turin, Turin, Italy
Search for more papers by this authorR. Cutrera MD
Respiratory Unit, Bambino Gesu' Children's Research Hospital, Rome, Italy
Search for more papers by this authorG. Ottonello MD
Anesthesiology and Intensive Care Medicine Unit, G. Gaslini Institute, Genoa, Italy
Search for more papers by this authorV.M. Ranieri MD
Department of Anesthesiology and Intensive Care Medicine, San Giovanni Battista-Molinette Hospital, University of Turin, Turin, Italy
Search for more papers by this authorI. Salvo MD
Department of Anesthesiology and Intensive Care, Vittore Buzzi Children's Hospital, Milan, Italy
Search for more papers by this authorR. Testa
Intensive Care Unit, Santobono Hospital, Naples, Italy
Search for more papers by this authorA. Wolfler MD
Department of Anesthesiology and Intensive Care, Vittore Buzzi Children's Hospital, Milan, Italy
Search for more papers by this authorCorresponding Author
M. Bonati MD
Department of Public Health, Laboratory for Mother and Child Health, “Mario Negri” Pharmacological Research Institute, Milan, Italy
Head of Department of Public Health and of the Laboratory for Mother and Child Health “Mario Negri” Pharmacological Research Institute Via Giuseppe La Masa 19, 20156 Milan, Italy.Search for more papers by this authoron behalf of the “LTV Pediatric Italian Network”
“LTV Pediatric Italian Network”: Anna Costantino, Alessandria; Raffaella Pagni, Ancona; Anna Maria Miorelli, Arco; Paolo Castaldi, Cagliari; Mariano Cabras, Carbonia; Bruno Dengo, Castelfranco Veneto; Augusto Biasini, Cesena; Francesco Morandi, Erba; Carlo Minetti, Giancarlo Ottonello, Genova; Paolo Banfi, Maurizio Bonati, Edoardo Calderini, Edi Prandi, Ida Salvo, Marco Sequi, Andrea Wolfler, Marco Zucconi, Milano; Giuseppe Fiorentino, Antonio Maddalena, Raffaele Testa, Napoli; Grazia Crescimanno, Anna Guddo, Palermo; Livio Carnevale, Pavia; Andrea Vianello, Padova; Giancarlo Piccinini, Ravenna; Valter Bottari, Reggio Emilia; Maurizio Corbari, Renato Cutrera, Martino Pavone, Roma; Giacomo Berta, Elisabetta Bignamini, Elena Capello, Lorenzo Del Sorbo, Cesare Gregoretti, Maria Maspoli, Fabrizio Racca, Marco V. Ranieri, Torino; Antonio Peratoner, Udine; Monica Benedetti, Verona.
Search for more papers by this authorAbstract
Background
Improved technology, as well as professional and parental awareness, enable many ventilator-dependent children to live at home. However, the profile of this growing population, the quality and adequacy of home care, and patients' needs still require thorough assessment.
Objectives
To define the characteristics of Italian children receiving long-term home mechanical ventilation (HMV) in Italy.
Methods
A detailed questionnaire was sent to 302 National Health Service hospitals potentially involved in the care of HVM in children (aged <17 years). Information was collected on patient characteristics, type of ventilation, and home respiratory care.
Results
A total of 362 HMV children was identified. The prevalence was 4.2 per 100,000 (95% CI: 3.8–4.6), median age was 8 years (interquartile range 4–14), median age at starting mechanical ventilation was 4 years (1–11), and 56% were male. The most frequent diagnostic categories were neuromuscular disorders (49%), lung and upper respiratory tract diseases (18%), hypoxic (ischemic) encephalopathy (13%), and abnormal ventilation control (12%). Medical professionals with nurses (for 62% of children) and physiotherapists (20%) participated in the patients' discharge from hospital, though parents were the primary care giver, and in 47% of cases, the sole care giver. Invasive ventilation was used in 41% and was significantly related to young age, southern regional residence, longer time spent under mechanical ventilation, neuromuscular disorders, or hypoxic (ischemic) encephalopathy.
Conclusions
Care and technical assistance of long-term HMV children need assessment, planning, and resources. A wide variability in pattern of HMV was found throughout Italy. An Italian national ventilation program, as well as a national registry, could be useful in improving the care of these often critically ill children. Pediatr. Pulmonol. 2011; 46:566–572. © 2011 Wiley-Liss, Inc.
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