Long-Term Home Noninvasive Ventilation Program in Children: 17 Years of Follow-Up From a Tertiary Center in Chile.

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Pulmonology Pub Date : 2025-07-01 DOI:10.1002/ppul.71198

Gerardo Torres-Puebla, Daniel Zenteno Araos, Javiera Flores Arrey, Roberto Vera-Uribe, Jaime Tapia Zapatero

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引用次数: 0

Abstract

Introduction: Established in 2006, Chile's National Program of Noninvasive Mechanical Ventilation (NIV) provides continuous home ventilatory support.

Objective: To provide an overview of the NIV Program in children and adolescents at a tertiary care center in Chile.

Materials and methods: A retrospective study analyzed children in the NIV Program at a tertiary hospital from 2006 to 2023. We examined demographic characteristics, program duration, and respiratory, polygraphic, and gasometric variables, along with NIV initiation criteria. Statistical tests evaluated factors linked to program permanence, survival, and discharge outcomes. Data were divided into equal time periods for analysis.

Results: A total of 113 children were included (median age: 8.3 years; IQR: 3.2-12.8). At the time of analysis, 51.3% continued in the program. The most common diagnoses were neuromuscular disease (NMD, 38.9%), central nervous system disorder (30.1%), and upper airway obstruction (14.2%). The age for NIV initiation was significantly lower in 2018-2020 compared to 2009-2011 (p < 0.05). The annual admission rate was 7.3 patients, with 3.1 discharges. The median program duration was 7 years (IQR: 5-11), varying by discharge reason (p < 0.001). Of the 55 discharged patients, 30.9% transitioned to adult care, 23.6% died, and 21.8% improved. The 5-year survival and ventilator discharge incidences were 88% and 67%, respectively. NIV was primarily initiated based on clinical (44%) and polygraphic (19%) criteria.

Conclusions: NMD was the most prevalent diagnosis at the start of NIV and the main condition linked to the transition to adult care. NIV initiation occurred earlier over time, with high 5-year survival rates.

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儿童长期家庭无创通气项目：智利某三级中心17年随访

智利国家无创机械通气项目（NIV）成立于2006年，提供持续的家庭通气支持。目的：提供在智利三级保健中心的儿童和青少年的NIV程序的概述。材料和方法：一项回顾性研究分析了2006年至2023年在一家三级医院参加NIV项目的儿童。我们检查了人口统计学特征、项目持续时间、呼吸、测谎和气体测量变量，以及NIV启动标准。统计测试评估了与项目持久性、存活率和出院结果相关的因素。数据被分成相等的时间段进行分析。结果：共纳入113例儿童(中位年龄：8.3岁；差:3.2 - -12.8)。在分析时，51.3%的人继续参加该计划。最常见的诊断是神经肌肉疾病（NMD, 38.9%）、中枢神经系统疾病（30.1%）和上呼吸道阻塞（14.2%）。与2009-2011年相比，2018-2020年开始使用NIV的年龄显著降低(p)。结论：NMD是开始使用NIV时最普遍的诊断，也是与向成人护理过渡相关的主要疾病。随着时间的推移，NIV的起始时间越早，5年生存率越高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Pulmonology 医学-呼吸系统

CiteScore

6.00

自引率

12.90%

发文量

468

审稿时长

3-8 weeks

期刊介绍： Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.