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Clinical Study of Children Using Home Mechanical Ventilation

Korean Journal of Pediatrics 2005;48(4):401-405.
Published online April 15, 2005.
Clinical Study of Children Using Home Mechanical Ventilation
Young Joon Ahn1, Seung Hyeon Lee1, Hyo-Bin Kim2, Seong Jong Park2, Tae Sung Ko2, Soo-Jong Hong2
1Department of Pediatrics, Nam Gwang Hospital, College of Medicine, Seonam University, Namwon, Korea
2Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
가정용 인공 호흡기를 사용하는 소아의 임상적 고찰
안영준1, 이승현1, 김효빈2, 박성종2, 고태성2, 홍수종2
1서남대학교 의과대학 남광병원 소아과
2 울산대학교 의과대학 서울아산병원 소아과
Correspondence: 
Soo-Jong Hong, Email: sjhong@amc.seoul.kr
Abstract
Purpose
: The use of mechanically-assisted ventilators at home reduces morbidity and improves the quality of life in children with chronic respiratory failure. But in Korea there is no clinical data of children with home mechanical ventilation. We investigated ventilator types, duration, the causes of failure or death, and the cost needed for care.
Methods
: We retrospectively analyzed the medical records of 21 children who were admitted and who applied for home mechanical ventilation at the Pediatric Intensive Care Unit in Asan Medical Center. Phone interviews took place after discharge. and interviewed by phone after discharge.
Results
: The median age was 31 months; the median duration with ventilator was 25 months. Underlying diseases were 16 neuromuscular diseases, one metabolic disease and four chronic respiratory diseases. The types of ventilator were pressure and volume type(16 and five patients, respectively). The frequency of ventilation failure was once per 19 months. Weaning could be performed in three cases. Frequencies of admission after receiving ventilators were 1.7 times per year; the most common cause was pneumonia. Nine patients(43%) died; four of them died because of endotracheal tube obstruction. The costs for medical care were about 1,110,000 won per month.
Conclusion
: There is an increment in the numbers of individuals who need mechanical ventilation support. The most common cause of death was endotracheal tube obstruction. The most important problem for the patients was medical cost. There needs to be more interest in patients with ventilator and social welfare systems to support their families need to be prepared.
Key Words: Home mechanical ventilation , Ventilator failure , Tube obstruction , Children


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