Allergy Asthma Respir Dis.  2016 May;4(3):195-198. 10.4168/aard.2016.4.3.195.

A study of the use of home mechanical ventilator and medical insurance

• Mun SW
• Kim HY
• Kim HY
• Park HJ
• Kim SY
• Shin YB
• Son SK

• KMID: 2165081
• DOI: http://doi.org/10.4168/aard.2016.4.3.195

Abstract

PURPOSE
Use of a home mechanical ventilator can shorten the hospitalization duration of children with chronic respiratory failure requiring long-term use of a mechanical ventilator. In this study, the researchers analyzed patients who had used a home mechanical ventilator.
METHODS
From January 2009 to July 2014, we retrospectively investigated 15 patients under 18 years of age, from 2 hospitals, and their use of home mechanical ventilators.
RESULTS
The median age of the patients was 55 months. Ten children were male, and 5 were female. As for the type of mechanical ventilators, 10 used a pressure type, 3 used a volume type, and 2 used a volume-mask type. Analysis of underlying diseases revealed that 10 children had neuromuscular disease, 3 had pulmonary disease, and 2 suffered from hypoxic ischemic encephalopathy. The number of patients who were discharged from the hospital with a home mechanical ventilator was 13. One child died of sepsis irrespective of the mechanical ventilator. Six patients had health insurance. But 9 did not. The group with insurance had the possibility of being discharged earlier than the group without. On readmission, the length of hospitalization was also reduced in patients who had used a home mechanical ventilator.
CONCLUSION
Use of a mechanical ventilator at home is helpful in patients who need long-term use of a mechanical ventilator due to neuromuscular disease, chronic pulmonary diseases, and accidents because complications are rare and insurance coverage is feasible.

Keyword

Mechanical ventilator; Home; Child

MeSH Terms

Child
Female
Hospitalization
Humans
Hypoxia-Ischemia, Brain
Insurance Coverage
Insurance*
Insurance, Health
Lung Diseases
Male
Neuromuscular Diseases
Respiratory Insufficiency
Retrospective Studies
Sepsis
Ventilators, Mechanical*

Reference

References

1. Suh J, Lee JH, Chung MK, Jeong HS, Son YI, Ahn K, et al. Causes and outcome of tracheostomy in children. Pediatr Allergy Respir Dis. 2012; 22:188–96.

2. King AC. longterm home mechanical ventilation in the United States. Respir Care. 2012; 57:921–30.

3. Torres A, Aznar R, Gatell JM, Jimenez P, Gonzalez J, Ferrer A, et al. Incidence, risk, and prognosis factors of nosocomial pneumonia in mechanically ventilated patients. Am Rev Respir Dis. 1990; 142:523–8.

4. Ahn YJ, Lee SH, Kim HB, Park SJ, Ko TS, Hong SJ. Clinical study of children using home mechanical ventilation. Korean J Pediatr. 2005; 48:401–5.

5. Kim KO, Oh AY, Lee CJ, Park CD, Kim CS. Home mechanical ventilation of pediatric patients. Korean J Anesthesiol. 2003; 44:229–34.

6. Cancelinha C, Madureira N, Macao P, Pleno P, Silva T, Estevao MH, et al. longterm ventilation in children: ten years later. Rev Port Pneumol (2006). 2015; 21:16–21.

7. Kim MH, Kim HS, Park JD. Factors Influencing Readmission of Home Ventilator-Assisted Children. J Korean Acad Child Health Nurs. 2012; 18:9–18.

8. Han YJ, Park JD, Lee B, Choi YH, Suh DI, Lim BC, et al. Home mechanical ventilation in childhood-onset hereditary neuromuscular diseases: 13 years' experience at a single center in Korea. PLoS One. 2015; 10:e0122346.

9. Amin RS, Fitton CM. Tracheostomy and home ventilation in children. Semin Neonatol. 2003; 8:127–35.