Care alternatives for pediatric chronic mechanical ventilation

J Pediatr (Rio J). 2011 Mar-Apr;87(2):145-9. doi: 10.2223/JPED.2072.
[Article in English, Portuguese]


Objective: To determine the impact of transferring a pediatric population to mechanical ventilator dependency units (MVDUs) or to home mechanical ventilation (HMV) on bed availability in the pediatric intensive care unit (ICU).

Methods: This is a longitudinal, retrospective study of hospitalized children who required prolonged mechanical ventilation at the MVDU located at the Hospital Auxiliar de Suzano, a secondary public hospital in São Paulo, Brazil. We calculated the number of days patients spent at MVDU and on HMV, and analyzed their survival rates with Kaplan-Meier estimator.

Results: Forty-one patients were admitted to the MVDU in 7.3 years. Median length of stay in this unit was 239 days (interquartile range = 102-479). Of these patients, 22 came from the ICU, where their transfer made available 8,643 bed-days (a mean of 14 new patients per month). HMV of eight patients made 4,022 bed-days available in the hospital in 4 years (a mean of 12 new patients per month in the ICU). Survival rates of patients at home were not significantly different from those observed in hospitalized patients.

Conclusions: A hospital unit for mechanical ventilator-dependent patients and HMV can improve bed availability in ICUs. Survival rates of patients who receive HMV are not significantly different from those of patients who remain hospitalized.

MeSH terms

  • Child
  • Female
  • Home Care Services / statistics & numerical data*
  • Hospital Bed Capacity / statistics & numerical data*
  • Humans
  • Intensive Care Units, Pediatric / statistics & numerical data*
  • Kaplan-Meier Estimate
  • Length of Stay / statistics & numerical data
  • Male
  • Patient Transfer / statistics & numerical data*
  • Respiration, Artificial / methods*
  • Respiration, Artificial / mortality
  • Respiratory Care Units / statistics & numerical data*
  • Retrospective Studies