Long-Term Ventilation in Children with Medical Complexity: A Challenging Issue

Long-Term Ventilation in Children with Medical Complexity: A Challenging Issue

Caldarelli V; Porcaro F; Filippo PD; Attanasi M; Fainardi V; Gallucci M; Mazza A; Ullmann N; Grutta SL

Children

2022

Child; child; human; children with medical complexity; ethics; palliative therapy; review; Ventilators, Mechanical; long term care; Only Child; treatment indication; artificial ventilation; continuous positive airway pressure; invasive ventilation; miscellaneous named groups

Children with medical complexity (CMCs) represent a subgroup of children who may have congenital or acquired multisystemic disease. CMCs are frequently predisposed to respiratory problems and often require long-term mechanical ventilation (LTMV). The indications for LTMV in CMCs are increasing, but gathering evidence about indications, titration, and monitoring is currently the most difficult challenge due to the absence of validated data. The aim of this review was to examine the clinical indications and ethical considerations for the initiation, continuation, or withdrawal of LTMV among CMCs. The decision to initiate long-term ventilation should always be based on clinical and ethical considerations and should be shared with the parents.

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September List 2023