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Eur J Pediatr. 2011 Sep;170(9):1187-92. doi: 10.1007/s00431-011-1430-9. Epub 2011 Mar 1.

Increasing prevalence of domiciliary ventilation: changes in service demand and provision in the South West of the UK.

Author information

1
Paediatric Intensive Care Unit, Bristol Royal Hospital for Children, Bristol, BS2 8BJ, UK. sarahgoodwin@nhs.net

Abstract

We examine the incidence and prevalence of domiciliary ventilation in the South West region of the UK, assess trends over 15 years, and describe patient outcome. We conducted a retrospective review of all patients below 18 years receiving domiciliary ventilation in the South West region of the UK between January 1994 and August 2009. Children who received long-term ventilation solely in hospital were excluded from the study. Information was obtained from a locally held database, medical notes, and hospital administration systems. One hundred-six patients were identified. Prevalence has increased since 1994 from 0.2 to 6.7 per 100,000 children. The incidence of both invasive and non-invasive ventilations has increased with a trend towards more non-invasive therapy. The commonest underlying disorders were airway pathology (37 patients), neuromuscular disease (34 patients), and central congenital hypoventilation disorder (17 patients). Sixty-seven patients had significant co-morbidities. Of 38 non-current patients, 19 were transferred to adult ventilation services, 11 died, and 6 were successfully weaned from ventilatory support. In conclusion, there has been a 30-fold increase in the prevalence of paediatric domiciliary ventilation, in the South West region of the UK, since 1994. Co-morbidities are common. Very few children discontinue long-term ventilation, and increasing numbers of ventilated children are transferred to adult services.

PMID:
21360027
DOI:
10.1007/s00431-011-1430-9
[Indexed for MEDLINE]

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