Treinta años de ventilación mecánica domiciliaria en niños: necesidad creciente de camas en cuidados intensivos pediátricos
Thirty years of home mechanical ventilation in children: escalating need for pediatric intensive care beds.
Paulides FM, Plötz FB, Verweij-van den Oudenrijn LP, van Gestel JP, Kampelmacher MJ. Department of Pediatric Intensive Care, VU Medical Center, Amsterdam, The Netherlands.
Intensive Care Med. 2012 May;38(5):847-52.
Abstract
PURPOSE: To describe trends in pediatric home mechanical ventilation (HMV) and their impact on the use of pediatric intensive care unit (PICU) beds. METHODS: Review of all children who had started HMV in a single center for HMV. RESULTS: Between 1979 and 2009, HMV was started in 197 patients [100 (51%) with invasive and 97 with noninvasive ventilation], with a median age of 14.7 (range 0.5-17.9) years. Most patients (77%) were males with a neuromuscular disorder (66%). The number of children receiving HMV increased from 8 in the 1979-1988 period to 122 in the 1999-2008 period. This increase occurred foremost in patients aged 0-5 years and was accompanied by a sharp rise in the use of PICU beds. In 150 patients (76%), HMV was initiated on an ICU with a total of 12,440 admission days, of which 10,385 days (83%) could be attributed to 67 patients who started non-electively with invasive HMV. Of the latter, 52 patients had been admitted to a PICU with a total of 9,335 admission days. At the end of the study, 134 patients (68%) were still being ventilated, 43 patients (22%) had died, 11 patients (6%) were weaned from HMV, 4 patients (2%) did not want to continue HMV and 5 patients (3%) were lost to follow-up. CONCLUSIONS: Over time, there was an impressive increase in the application of HMV in children. This increase was most obvious in the youngest age group with invasive HMV, and these children had very long stays in the PICU.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3332376/pdf/134_
2012_Article_2545.pdf
Ventilación no invasiva fuera del hospital; epidemiología, tecnología y equipo
Out-of-hospital noninvasive ventilation: epidemiology, technology and equipment.
Baird JS, Ravindranath TM.
Division of Pediatric Critical Care, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, USA.
Pediatr Rep. 2012 Apr 2;4(2):e17. Epub 2012 Apr 24.
Abstract
Noninvasive ventilation has been utilized successfully in the pre- and out-of-hospital settings for a variety of disorders, including respiratory distress syndrome in neonates, neurologic and pulmonary diseases in infants and children, and heart failure as well as chronic obstructive pulmonary disease in adults. A variety of interfaces as well as mechanical positive pressure devices have been used: simple continuous positive airway pressure devices are available which do not require sophisticated equipment, while a broad spectrum of ventilators have been used to provide bilevel positive airway pressure. Extensive training of transport teams may be important, particularly when utilizing bilevel positive airway pressure in infants and children
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3395975/pdf/pr-2012-2-e17.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Thirty years of home mechanical ventilation in children: escalating need for pediatric intensive care beds.
Paulides FM, Plötz FB, Verweij-van den Oudenrijn LP, van Gestel JP, Kampelmacher MJ. Department of Pediatric Intensive Care, VU Medical Center, Amsterdam, The Netherlands.
Intensive Care Med. 2012 May;38(5):847-52.
Abstract
PURPOSE: To describe trends in pediatric home mechanical ventilation (HMV) and their impact on the use of pediatric intensive care unit (PICU) beds. METHODS: Review of all children who had started HMV in a single center for HMV. RESULTS: Between 1979 and 2009, HMV was started in 197 patients [100 (51%) with invasive and 97 with noninvasive ventilation], with a median age of 14.7 (range 0.5-17.9) years. Most patients (77%) were males with a neuromuscular disorder (66%). The number of children receiving HMV increased from 8 in the 1979-1988 period to 122 in the 1999-2008 period. This increase occurred foremost in patients aged 0-5 years and was accompanied by a sharp rise in the use of PICU beds. In 150 patients (76%), HMV was initiated on an ICU with a total of 12,440 admission days, of which 10,385 days (83%) could be attributed to 67 patients who started non-electively with invasive HMV. Of the latter, 52 patients had been admitted to a PICU with a total of 9,335 admission days. At the end of the study, 134 patients (68%) were still being ventilated, 43 patients (22%) had died, 11 patients (6%) were weaned from HMV, 4 patients (2%) did not want to continue HMV and 5 patients (3%) were lost to follow-up. CONCLUSIONS: Over time, there was an impressive increase in the application of HMV in children. This increase was most obvious in the youngest age group with invasive HMV, and these children had very long stays in the PICU.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3332376/pdf/134_
2012_Article_2545.pdf
Ventilación no invasiva fuera del hospital; epidemiología, tecnología y equipo
Out-of-hospital noninvasive ventilation: epidemiology, technology and equipment.
Baird JS, Ravindranath TM.
Division of Pediatric Critical Care, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, USA.
Pediatr Rep. 2012 Apr 2;4(2):e17. Epub 2012 Apr 24.
Abstract
Noninvasive ventilation has been utilized successfully in the pre- and out-of-hospital settings for a variety of disorders, including respiratory distress syndrome in neonates, neurologic and pulmonary diseases in infants and children, and heart failure as well as chronic obstructive pulmonary disease in adults. A variety of interfaces as well as mechanical positive pressure devices have been used: simple continuous positive airway pressure devices are available which do not require sophisticated equipment, while a broad spectrum of ventilators have been used to provide bilevel positive airway pressure. Extensive training of transport teams may be important, particularly when utilizing bilevel positive airway pressure in infants and children
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3395975/pdf/pr-2012-2-e17.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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