González Cortés R, Bustinza Arriortua A, Pons Ódena M, García Teresa M A, Cols Roig M, Gaboli M, García Martinez S, Oñate Vergara E, García Urabayen D, Castillo Serrano A, López González J, Salcedo Posadas A, Rodríguez Nuñez A, Luna Paredes M C, Hernández González A, González Hervas C, Medina Villanueva A, Pérez Ruíz E, Callejón Callejón A, Tosca Segura R, Herranz Aguirre M, Lamas Ferreiro A, López-Herce Cid J
Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Madrid, España.
An Pediatr (Barc). 2013 Apr;78(4):227-33. doi: 10.1016/j.anpedi.2012.06.011. Epub 2012 Sep 6.
Domiciliary mechanical ventilation (DMV) use is increasing in children. Few studies have analysed the characteristics of patients using this technique.
An observational, descriptive, transversal, multicentre study was conducted on patients between 1 month and 16 years of age dependent on domiciliary mechanical ventilation.
A total of 163 patients with a median age of 7.6 years from 17 Spanish hospitals were studied. The main reasons for DMV were neuromuscular disorders. The median age at beginning of DMV was 4.6 years. Almost three-quarters (71.3%) received non-invasive ventilation. Patients depending on invasive ventilation were younger, started DMV at an earlier age, and had more hours of mechanical ventilation per day. The large majority (80.9%) used DMV during sleep time only, and 11.7% during the whole day. Only 3.4% of patients had external health assistance. Just under half (48.2%) were being followed up in specific DMV or multidisciplinary clinics. Almost three-quarters (72.1%) of patients attended school (42.3% with adapted schooling). Only 47.8% of school patients had specific caregivers in their schools.
DMV in children is used in a very heterogeneous group of patients, and in an important number of patients it is started before the third year of life. Despite there being a significant proportion of patients with a high dependency on DMV, few families receive specific support at home or at school, and health care surveillance is variable and poorly coordinated.
家庭机械通气（DMV）在儿童中的使用正在增加。很少有研究分析使用这种技术的患者特征。
对1个月至16岁依赖家庭机械通气的患者进行了一项观察性、描述性、横断面、多中心研究。
对来自17家西班牙医院的163例中位年龄为7.6岁的患者进行了研究。DMV的主要原因是神经肌肉疾病。DMV开始时的中位年龄为4.6岁。近四分之三（71.3%）接受无创通气。依赖有创通气的患者年龄更小，开始DMV的年龄更早，且每天机械通气时间更长。绝大多数（80.9%）仅在睡眠时间使用DMV，11.7%在全天使用。只有3.4%的患者获得外部健康援助。不到一半（48.2%）的患者在特定的DMV或多学科诊所接受随访。近四分之三（72.1%）的患者上学（42.3%接受适应性教育）。在上学的患者中，只有47.8%在学校有特定的护理人员。
儿童DMV应用于非常不同的患者群体，并且在相当数量的患者中，DMV在生命的第三年之前就开始使用。尽管有很大比例的患者高度依赖DMV，但很少有家庭在家庭或学校获得特定支持，并且医疗保健监测参差不齐且协调不佳。
