To describe the demographic and clinical characteristics of and type of respiratory technology utilized by respiratory technology dependent children (RTDC) in Manitoba (1982-2005).
Demographic and clinical data (age, sex, underlying condition) were collected retrospectively together with specific information regarding respiratory technology utilized (oxygen, tracheostomy, non-invasive or invasive ventilation –continuous or nocturnal) and current location/situation.
In 1982 the first ventilated child was sent home on an LP3 ventilator. The establishment of the Pediatric Sleep Program in 1989 contributed to more children requiring ventilator support. Majority of the 115 children dependent on respiratory technology since 1982 have been managed at home. Ventilatory support was discontinued in twenty-nine patients and thirteen were successfully decannulated. Seventeen children have been transitioned to the Adult Program. Mortality rate is 16.5% (19/115). The current population of RTDC in Manitoba consists of 11 children ventilated by tracheostomy and 20 who receive support non-invasively at home; another 15 children have tracheostomy tubes only and 17 receive oxygen supplementation. Only two tracheostomized/ventilated and 2 tracheostomized children remain in hospital. One patient on BiPap support remains admitted (requiring other therapies). Patients’ underlying conditions were classified as neuromuscular diseases, central nervous system disorders, spinal injuries, craniofacial syndromes, chronic respiratory diseases (BPD, BOOP) and others (tracheomalacia, trauma, etc). Tracheostomized/ventilated children require on average 1-2 hospitalizations/year while children with tracheostomy tubes or O2 only are admitted 0-1 times/year. All patients managed at home are assessed at least 2-4 times/year at the Technology Dependent Children’s Clinic.
Majority of RTDC children in Manitoba have been and are successfully cared for at home.
Advanced medical technology and developments in critical care have increased the number of children with chronic medical conditions that are dependent on respiratory technology. Together with a well-structured Home Care Program, dedicated efforts of Respiratory Therapists, Pediatric nurses and Specialists, majority of these patients can be managed effectively in the home setting.
Raquel Consunji-Araneta, None.