Outcomes of Children Treated With Tracheostomy and Positive-Pressure Ventilation at Home
Background. Long-term outcomes for children who survive on tracheostomy and positive-pressure ventilation (TPPV) at home are not well known. Methods. A retrospective review of 20 years of clinical data at a single institution was performed. Outcome measures included 5-year survival, decannulation ra...
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| Veröffentlicht in: | Clinical pediatrics 2013-01, Vol.52 (1), p.54-61 |
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| creator | Com, Gulnur Kuo, Dennis Z. Bauer, Martin L. Lenker, Claire V. Melguizo-Castro, Maria M. Nick, Todd G. Makris, Christopher M. |
| description | Background. Long-term outcomes for children who survive on tracheostomy and positive-pressure ventilation (TPPV) at home are not well known. Methods. A retrospective review of 20 years of clinical data at a single institution was performed. Outcome measures included 5-year survival, decannulation rate, and neurocognition. Results. A total of 91 children were categorized under neuromotor dysfunction (52%), chronic lung disease (29%), and congenital anomalies (20%). The 5-year survival rates for these categories were 89% (95% confidence interval [CI] = 80%-99%), 76% (95% CI = 57%-100%), and 94% (95% CI = 83%-100%), respectively. Overall, the 5-year decannulation rate was 25% (95% CI = 14%-35%), with children with chronic lung disease having the highest rate (51%). It was found that 14% were extremely delayed in neurocognition. Conclusion. Most children on TPPV at home survive beyond 5 years, and a significant number are decannulated. Primary care physicians and communities should be prepared to accommodate the increasing number of children on TPPV at home. |
| doi_str_mv | 10.1177/0009922812465943 |
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Long-term outcomes for children who survive on tracheostomy and positive-pressure ventilation (TPPV) at home are not well known. Methods. A retrospective review of 20 years of clinical data at a single institution was performed. Outcome measures included 5-year survival, decannulation rate, and neurocognition. Results. A total of 91 children were categorized under neuromotor dysfunction (52%), chronic lung disease (29%), and congenital anomalies (20%). The 5-year survival rates for these categories were 89% (95% confidence interval [CI] = 80%-99%), 76% (95% CI = 57%-100%), and 94% (95% CI = 83%-100%), respectively. Overall, the 5-year decannulation rate was 25% (95% CI = 14%-35%), with children with chronic lung disease having the highest rate (51%). It was found that 14% were extremely delayed in neurocognition. Conclusion. Most children on TPPV at home survive beyond 5 years, and a significant number are decannulated. Primary care physicians and communities should be prepared to accommodate the increasing number of children on TPPV at home.</description><identifier>ISSN: 0009-9228</identifier><identifier>EISSN: 1938-2707</identifier><identifier>DOI: 10.1177/0009922812465943</identifier><identifier>PMID: 23155195</identifier><identifier>CODEN: CPEDAM</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Central Nervous System Diseases - mortality ; Central Nervous System Diseases - therapy ; Child, Preschool ; Chronic Disease ; Clinical outcomes ; Congenital Abnormalities - mortality ; Female ; Home Care Services, Hospital-Based ; Humans ; Infant ; Kaplan-Meier Estimate ; Lung Diseases - mortality ; Lung Diseases - therapy ; Male ; Neurosciences ; Pedestrians ; Positive-Pressure Respiration - mortality ; Primary care ; Respiratory Insufficiency - mortality ; Respiratory Insufficiency - therapy ; Retrospective Studies ; Survival analysis ; Tracheostomy - mortality ; Ventilation</subject><ispartof>Clinical pediatrics, 2013-01, Vol.52 (1), p.54-61</ispartof><rights>The Author(s) 2013</rights><rights>Copyright Westminster Publications, Inc. Jan 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-ded8128995d302ea080ed7cef4d91ac2becb4564c45271b176a699a85b7f3c8d3</citedby><cites>FETCH-LOGICAL-c365t-ded8128995d302ea080ed7cef4d91ac2becb4564c45271b176a699a85b7f3c8d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0009922812465943$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0009922812465943$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23155195$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Com, Gulnur</creatorcontrib><creatorcontrib>Kuo, Dennis Z.</creatorcontrib><creatorcontrib>Bauer, Martin L.</creatorcontrib><creatorcontrib>Lenker, Claire V.</creatorcontrib><creatorcontrib>Melguizo-Castro, Maria M.</creatorcontrib><creatorcontrib>Nick, Todd G.</creatorcontrib><creatorcontrib>Makris, Christopher M.</creatorcontrib><title>Outcomes of Children Treated With Tracheostomy and Positive-Pressure Ventilation at Home</title><title>Clinical pediatrics</title><addtitle>Clin Pediatr (Phila)</addtitle><description>Background. Long-term outcomes for children who survive on tracheostomy and positive-pressure ventilation (TPPV) at home are not well known. Methods. A retrospective review of 20 years of clinical data at a single institution was performed. Outcome measures included 5-year survival, decannulation rate, and neurocognition. Results. A total of 91 children were categorized under neuromotor dysfunction (52%), chronic lung disease (29%), and congenital anomalies (20%). The 5-year survival rates for these categories were 89% (95% confidence interval [CI] = 80%-99%), 76% (95% CI = 57%-100%), and 94% (95% CI = 83%-100%), respectively. Overall, the 5-year decannulation rate was 25% (95% CI = 14%-35%), with children with chronic lung disease having the highest rate (51%). It was found that 14% were extremely delayed in neurocognition. Conclusion. Most children on TPPV at home survive beyond 5 years, and a significant number are decannulated. Primary care physicians and communities should be prepared to accommodate the increasing number of children on TPPV at home.</description><subject>Central Nervous System Diseases - mortality</subject><subject>Central Nervous System Diseases - therapy</subject><subject>Child, Preschool</subject><subject>Chronic Disease</subject><subject>Clinical outcomes</subject><subject>Congenital Abnormalities - mortality</subject><subject>Female</subject><subject>Home Care Services, Hospital-Based</subject><subject>Humans</subject><subject>Infant</subject><subject>Kaplan-Meier Estimate</subject><subject>Lung Diseases - mortality</subject><subject>Lung Diseases - therapy</subject><subject>Male</subject><subject>Neurosciences</subject><subject>Pedestrians</subject><subject>Positive-Pressure Respiration - mortality</subject><subject>Primary care</subject><subject>Respiratory Insufficiency - mortality</subject><subject>Respiratory Insufficiency - therapy</subject><subject>Retrospective Studies</subject><subject>Survival analysis</subject><subject>Tracheostomy - mortality</subject><subject>Ventilation</subject><issn>0009-9228</issn><issn>1938-2707</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMtLxDAQxoMouj7uniTgxUs1z6Y5yuILBD2sj1tJk6lbaRtNUsH_3pZdRQRhYBi-33wzfAgdUnJKqVJnhBCtGSsoE7nUgm-gGdW8yJgiahPNJjmb9B20G-MrIZQTybfRDuNUSqrlDD3fDcn6DiL2NZ4vm9YF6PEigEng8FOTluNg7BJ8TL77xKZ3-N7HJjUfkN0HiHEIgB-hT01rUuN7bBK-Hg330VZt2ggH676HHi4vFvPr7Pbu6mZ-fptZnsuUOXDj94XW0nHCwJCCgFMWauE0NZZVYCshc2GFZIpWVOUm19oUslI1t4Xje-hk5fsW_PsAMZVdEy20renBD7GkTPGpNB3R4z_oqx9CP343UoKJosjFRJEVZYOPMUBdvoWmM-GzpKScUi__pj6uHK2Nh6oD97PwHfMIZCsgmhf4dfU_wy_sYYkD</recordid><startdate>201301</startdate><enddate>201301</enddate><creator>Com, Gulnur</creator><creator>Kuo, Dennis Z.</creator><creator>Bauer, Martin L.</creator><creator>Lenker, Claire V.</creator><creator>Melguizo-Castro, Maria M.</creator><creator>Nick, Todd G.</creator><creator>Makris, Christopher M.</creator><general>SAGE Publications</general><general>Westminster Publications, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7QR</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201301</creationdate><title>Outcomes of Children Treated With Tracheostomy and Positive-Pressure Ventilation at Home</title><author>Com, Gulnur ; Kuo, Dennis Z. ; Bauer, Martin L. ; Lenker, Claire V. ; Melguizo-Castro, Maria M. ; Nick, Todd G. ; Makris, Christopher M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-ded8128995d302ea080ed7cef4d91ac2becb4564c45271b176a699a85b7f3c8d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Central Nervous System Diseases - mortality</topic><topic>Central Nervous System Diseases - therapy</topic><topic>Child, Preschool</topic><topic>Chronic Disease</topic><topic>Clinical outcomes</topic><topic>Congenital Abnormalities - mortality</topic><topic>Female</topic><topic>Home Care Services, Hospital-Based</topic><topic>Humans</topic><topic>Infant</topic><topic>Kaplan-Meier Estimate</topic><topic>Lung Diseases - mortality</topic><topic>Lung Diseases - therapy</topic><topic>Male</topic><topic>Neurosciences</topic><topic>Pedestrians</topic><topic>Positive-Pressure Respiration - mortality</topic><topic>Primary care</topic><topic>Respiratory Insufficiency - mortality</topic><topic>Respiratory Insufficiency - therapy</topic><topic>Retrospective Studies</topic><topic>Survival analysis</topic><topic>Tracheostomy - mortality</topic><topic>Ventilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Com, Gulnur</creatorcontrib><creatorcontrib>Kuo, Dennis Z.</creatorcontrib><creatorcontrib>Bauer, Martin L.</creatorcontrib><creatorcontrib>Lenker, Claire V.</creatorcontrib><creatorcontrib>Melguizo-Castro, Maria M.</creatorcontrib><creatorcontrib>Nick, Todd G.</creatorcontrib><creatorcontrib>Makris, Christopher M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Com, Gulnur</au><au>Kuo, Dennis Z.</au><au>Bauer, Martin L.</au><au>Lenker, Claire V.</au><au>Melguizo-Castro, Maria M.</au><au>Nick, Todd G.</au><au>Makris, Christopher M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of Children Treated With Tracheostomy and Positive-Pressure Ventilation at Home</atitle><jtitle>Clinical pediatrics</jtitle><addtitle>Clin Pediatr (Phila)</addtitle><date>2013-01</date><risdate>2013</risdate><volume>52</volume><issue>1</issue><spage>54</spage><epage>61</epage><pages>54-61</pages><issn>0009-9228</issn><eissn>1938-2707</eissn><coden>CPEDAM</coden><abstract>Background. Long-term outcomes for children who survive on tracheostomy and positive-pressure ventilation (TPPV) at home are not well known. Methods. A retrospective review of 20 years of clinical data at a single institution was performed. Outcome measures included 5-year survival, decannulation rate, and neurocognition. Results. A total of 91 children were categorized under neuromotor dysfunction (52%), chronic lung disease (29%), and congenital anomalies (20%). The 5-year survival rates for these categories were 89% (95% confidence interval [CI] = 80%-99%), 76% (95% CI = 57%-100%), and 94% (95% CI = 83%-100%), respectively. Overall, the 5-year decannulation rate was 25% (95% CI = 14%-35%), with children with chronic lung disease having the highest rate (51%). It was found that 14% were extremely delayed in neurocognition. Conclusion. Most children on TPPV at home survive beyond 5 years, and a significant number are decannulated. Primary care physicians and communities should be prepared to accommodate the increasing number of children on TPPV at home.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>23155195</pmid><doi>10.1177/0009922812465943</doi><tpages>8</tpages></addata></record> |
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| subjects | Central Nervous System Diseases - mortality Central Nervous System Diseases - therapy Child, Preschool Chronic Disease Clinical outcomes Congenital Abnormalities - mortality Female Home Care Services, Hospital-Based Humans Infant Kaplan-Meier Estimate Lung Diseases - mortality Lung Diseases - therapy Male Neurosciences Pedestrians Positive-Pressure Respiration - mortality Primary care Respiratory Insufficiency - mortality Respiratory Insufficiency - therapy Retrospective Studies Survival analysis Tracheostomy - mortality Ventilation |
| title | Outcomes of Children Treated With Tracheostomy and Positive-Pressure Ventilation at Home |
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