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

Title

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

Creator

Edwards JD; Kun SS; Keens TG

Publisher

The Journal Of Pediatrics

Date

2010

Subject

Child; Humans; Cohort Studies; home care services; Positive-Pressure Respiration; Tracheostomy; Treatment Outcome; adolescent; Preschool; infant; retrospective studies; cause of death; Hospital-Based

Description

OBJECTIVE: To describe outcomes and causes of death in children on chronic positive-pressure ventilation via tracheostomy. STUDY DESIGN: 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. RESULTS: 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. CONCLUSION: 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.
2010

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

955-959.e2

Issue

6

Volume

157

Citation

Edwards JD; Kun SS; Keens TG, “Outcomes and causes of death in children on home mechanical ventilation via tracheostomy: an institutional and literature review,” Pediatric Palliative Care Library, accessed May 29, 2022, https://pedpalascnetlibrary.omeka.net/items/show/14367.

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