PURPOSE: Our study is designed to track patients and their clinical outcomes in the Home Ventilator Program at Helen DeVos Children's Hospital since 1998. The hypotheses are that most referrals come from our hospital and that the most common diagnosis for home ventilation is chronic lung disease of infancy (CLDI).
METHODS: This study analyzes a database developed to track patients in regards to their referral source, diagnosis requiring mechanical ventilation and outcomes. Patients admitted to our ICU's have been determined to require home ventilation & then are entered into our Home Ventilator program once discharge planning is initiated. Patients from outside our hospital can also be referred as outpatients or transferred here to complete discharge planning. All patients included in the study have tracheostomies. Patients receiving non-invasive mechanical ventilation are excluded. Study period is July 1998-April 2007.
RESULTS: 50 patients have entered the program. Referrals were from the following sources: 32% were from our NICU/26% from our PICU. 10% were transferred to our program from an outside ICU or rehabilitation hospital. 26% were referred as outpatients. 6% were patients from our own practice. 32% of the diagnoses are CLDI. 26% have neuromuscular conditions (MD, hypoxic/anoxic brain injury or c-spine injury). 20% have tracheomalacia or bronchomalacia. 10% have restrictive disease (e.g. congenital scoliosis, liver failure/liver transplantation). 12% have chronic respiratory failure related to severe developmental delay. 26% of our patients have graduated from mechanical ventilation. 8 patients have died over an 8 year period (6 after discharge home). 8% have transferred out of our care.
CONCLUSION: A children's hospital-based Home Ventilator Program receives referrals from a wide variety of sources. The diagnoses requiring home mechanical ventilation are diverse. Almost one third of our patient population have been able to be weaned from ventilatory support.
CLINICAL IMPLICATIONS: This database provides information regarding referral sources, trends in diagnoses and outcomes. Databases could be joined with other pediatric ventilator programs to advance our clinical knowledge and to foster quality improvement initiatives in this area.
DISCLOSURE: Susan Millard, No Financial Disclosure Information; No Product/Research Disclosure Information