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Canadian Respiratory Journal
Volume 22, Issue 2, Pages 103-108
http://dx.doi.org/10.1155/2015/107914
Original Article

How Long Does it Take to Initiate a Child on Long-Term Invasive Ventilation? Results From A Canadian Pediatric Home Ventilation Program

Reshma Amin,1,2 Aarti Sayal,1 Faiza Syed,1 Cathy Daniels,1,2 Andrea Hoffman,3 Theo J Moraes,1,2 and Peter Cox2,4

1Division of Respiratory Medicine, The Hospital for Sick Children, Canada
2Department of Pediatrics, University of Toronto, Canada
3Division of Pediatrics, Holland Bloorview Rehabilitation Hospital, Toronto, Ontario, Canada
4Division of Paediatric Critical Care Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada

Copyright © 2015 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

OBJECTIVE: To assess the length of stay required to initiate long-term invasive ventilation at the authors’ institution, which would inform future interventional strategies to streamline the in-hospital stay for these families.

METHODS: A retrospective chart review of children initiated on invasive long-term ventilation via tracheostomy at the authors’ acute care centre between January 2005 and December 2013 was performed.

RESULTS: Thirty-five children were initiated on long-term invasive ventilation via tracheostomy at the acute care hospital; 19 (54%) were male. The median age at time of admission was 0.52 years (interquartile range [IQR] 0.06 to 9.58 years). Musculoskeletal disease (n=11 [31%]) was the most common reason for tracheostomy insertion. Two children died during the hospital admission. Fifteen children were discharged home directly from the acute care hospital and 18 were moved to the rehabilitation hospital. Six are current inpatients of the rehabilitation centre and were never discharged home. Combining the length of stay at the acute care and rehabilitation hospitals for the entire cohort, the median length of stay was 162.0 days (IQR 98.0 to 275.0 days) and 97.0 days (IQR 69.0 to 210.0 days), respectively, from the time of tracheostomy insertion.

CONCLUSIONS: The median length of stay from the initiation of invasive long-term ventilation to discharge home from the rehabilitation hospital was somewhat long compared with other ventilation programs worldwide. Additionally, approximately 20% of the cohort never transitioned home. There is a timely need to benchmark across the country and internationally, to identify and implement strategies for cohesive, coordinated care for these children to decrease overall length of stay.