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Monitoring of physiologic features and treatment aspects of children on home invasive mechanical ventilation"
  • Jasneek Chawla,
  • Hui-leng Tan
Jasneek Chawla
Children's Health Queensland Hospital and Health Service
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Hui-leng Tan
Royal Brompton Hospital

Corresponding Author:[email protected]

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Abstract

Paediatric home invasive mechanical ventilation patients are a small but resource intensive cohort, requiring close monitoring and multidisciplinary care. Patients are often dependent on their ventilator for life support, with any significant complications such as equipment failure, tracheostomy blockage, or accidental decannulation becoming potentially life threatening, if not identified quickly. This review discusses the indications and variations in practice worldwide, in terms of models of care, including home care provision, choice of equipment and monitoring. With advances in technology, optimal monitoring strategies for home, continue to be debated: In-built ventilator alarms are often inadequately sensitive for paediatric patients, necessitating additional external monitoring devices to minimise risk. Pulse oximetry has been the preferred monitoring modality at home, though in some special circumstances such as congenital central hypoventilation syndrome, home carbon dioxide monitoring may be important to consider. Children should be under regular follow up at specialist respiratory centres where clinical evaluation, nocturnal oximetry and capnography monitoring and/or poly(somno)graphy and analysis of ventilator download data can be performed regularly to monitor progress. Recent exciting advances in technology, particularly in telemonitoring, which have potential to hugely benefit this complex group of patients are also discussed.
21 Sep 2023Submitted to Pediatric Pulmonology
21 Sep 2023Submission Checks Completed
21 Sep 2023Assigned to Editor
21 Sep 2023Review(s) Completed, Editorial Evaluation Pending
23 Sep 2023Reviewer(s) Assigned
18 Oct 2023Editorial Decision: Revise Minor
26 Jan 2024Review(s) Completed, Editorial Evaluation Pending
28 Jan 2024Editorial Decision: Accept