Send to

Choose Destination
J Pediatr. 2010 Dec;157(6):955-959.e2. doi: 10.1016/j.jpeds.2010.06.012. Epub 2010 Aug 14.

Outcomes and causes of death in children on home mechanical ventilation via tracheostomy: an institutional and literature review.

Author information

Division of Pediatric Critical Care, Department of Pediatrics, University of California, San Francisco, CA, USA.



To describe outcomes and causes of death in children on chronic positive-pressure ventilation via tracheostomy.


We conducted a retrospective observational cohort analysis of 228 children enrolled in an university-affiliated home mechanical ventilation (HMV) program over 22 years (990 person-years). Cumulative incidences of survival and liberation from HMV are presented. Time-to-events were compared by reason for chronic respiratory failure (CRF) and age and date of HMV initiation with Kaplan-Meier and Cox regression analyses. Circumstances of death are described.


Of our cohort, 47 of 228 children died, and 41 children were liberated from HMV. The 5-year cumulative incidences of survival and liberation were 80% and 24%, respectively. Being placed on HMV for chronic pulmonary disease was independently associated with liberation from HMV (hazard ratio, 7.38; 95% CI, 3.0-18.2; P < .001). Neither age nor reasons for CRF were associated with shortened survival. Progression of underlying condition accounted for only 34% of deaths; 49% of deaths were unexpected.


Most children on HMV survive or were weaned off. However, a sizable number of children in our cohort died, and many deaths were unexpected and from causes not directly related to their primary reason for CRF.

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center