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European Journal of Pediatrics

, Volume 170, Issue 9, pp 1187–1192 | Cite as

Increasing prevalence of domiciliary ventilation: changes in service demand and provision in the South West of the UK

  • Sarah Goodwin
  • Hayley Smith
  • Simon Langton Hewer
  • Peter Fleming
  • A. John Henderson
  • Tom Hilliard
  • James Fraser
Original Paper

Abstract

We examine the incidence and prevalence of domiciliary ventilation in the South West region of the UK, assess trends over 15 years, and describe patient outcome. We conducted a retrospective review of all patients below 18 years receiving domiciliary ventilation in the South West region of the UK between January 1994 and August 2009. Children who received long-term ventilation solely in hospital were excluded from the study. Information was obtained from a locally held database, medical notes, and hospital administration systems. One hundred-six patients were identified. Prevalence has increased since 1994 from 0.2 to 6.7 per 100,000 children. The incidence of both invasive and non-invasive ventilations has increased with a trend towards more non-invasive therapy. The commonest underlying disorders were airway pathology (37 patients), neuromuscular disease (34 patients), and central congenital hypoventilation disorder (17 patients). Sixty-seven patients had significant co-morbidities. Of 38 non-current patients, 19 were transferred to adult ventilation services, 11 died, and 6 were successfully weaned from ventilatory support. In conclusion, there has been a 30-fold increase in the prevalence of paediatric domiciliary ventilation, in the South West region of the UK, since 1994. Co-morbidities are common. Very few children discontinue long-term ventilation, and increasing numbers of ventilated children are transferred to adult services.

Keywords

Home ventilation Long-term ventilation Non-invasive ventilation Ventilator weaning 

Notes

Ethics approval

This study was defined as service evaluation by the National Research Ethics Service guidance; therefore, formal ethical approval was not required.

Conflict of interest

None.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Sarah Goodwin
    • 1
  • Hayley Smith
    • 3
  • Simon Langton Hewer
    • 3
  • Peter Fleming
    • 2
  • A. John Henderson
    • 3
  • Tom Hilliard
    • 3
  • James Fraser
    • 3
  1. 1.Paediatric Intensive Care UnitBristol Royal Hospital for ChildrenBristolUK
  2. 2.St Michael’s HospitalBristolUK
  3. 3.Bristol Royal Hospital for ChildrenBristolUK

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