All issues > Volume 48(4); 2005

Original Article

Korean J Pediatr. 2005;48(4):401-405. Published online April 15, 2005.

Clinical Study of Children Using Home Mechanical Ventilation

Young Joon YJ Ahn¹, Seung Hyeon SH Lee¹, Hyo-Bin HB Kim², Seong Jong SJ Park², Tae Sung TS Ko², Soo-Jong SJ 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

Correspondence Soo-Jong SJ 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.

Keywords :Home mechanical ventilation , Ventilator failure , Tube obstruction , Children