Long-term home ventilation of children in Italy: a national survey

Pediatr Pulmonol. 2011 Jun;46(6):566-72. doi: 10.1002/ppul.21401. Epub 2010 Dec 30.


Background: Improved technology, as well as professional and parental awareness, enable many ventilator-dependent children to live at home. However, the profile of this growing population, the quality and adequacy of home care, and patients' needs still require thorough assessment.

Objectives: To define the characteristics of Italian children receiving long-term home mechanical ventilation (HMV) in Italy.

Methods: A detailed questionnaire was sent to 302 National Health Service hospitals potentially involved in the care of HVM in children (aged <17 years). Information was collected on patient characteristics, type of ventilation, and home respiratory care.

Results: A total of 362 HMV children was identified. The prevalence was 4.2 per 100,000 (95% CI: 3.8-4.6), median age was 8 years (interquartile range 4-14), median age at starting mechanical ventilation was 4 years (1-11), and 56% were male. The most frequent diagnostic categories were neuromuscular disorders (49%), lung and upper respiratory tract diseases (18%), hypoxic (ischemic) encephalopathy (13%), and abnormal ventilation control (12%). Medical professionals with nurses (for 62% of children) and physiotherapists (20%) participated in the patients' discharge from hospital, though parents were the primary care giver, and in 47% of cases, the sole care giver. Invasive ventilation was used in 41% and was significantly related to young age, southern regional residence, longer time spent under mechanical ventilation, neuromuscular disorders, or hypoxic (ischemic) encephalopathy.

Conclusions: Care and technical assistance of long-term HMV children need assessment, planning, and resources. A wide variability in pattern of HMV was found throughout Italy. An Italian national ventilation program, as well as a national registry, could be useful in improving the care of these often critically ill children.

MeSH terms

  • Adolescent
  • Age Distribution
  • Child
  • Child, Preschool
  • Demography
  • Female
  • Home Care Services / standards
  • Home Care Services / statistics & numerical data*
  • House Calls / statistics & numerical data
  • Humans
  • Italy
  • Male
  • Monitoring, Physiologic
  • Patient Discharge / statistics & numerical data
  • Respiration, Artificial / standards
  • Respiration, Artificial / statistics & numerical data*
  • Respiratory Insufficiency / etiology
  • Respiratory Insufficiency / therapy*
  • Surveys and Questionnaires
  • Time Factors