Frates R C, Splaingard M L, Smith E O, Harrison G M
J Pediatr. 1985 May;106(5):850-6. doi: 10.1016/s0022-3476(85)80372-3.
A retrospective study of the outcome of home mechanical ventilation in 54 children with chronic respiratory insufficiency was conducted. The children's ages ranged from 4 months to 18 years. Tracheostomies and positive pressure ventilation were used in 33 patients, and negative pressure ventilation in 21 patients. Nine patients were eventually weaned from the ventilator, including three quadriplegic patients in whom electrophrenic stimulation subsequently was used. Over 20 years, there were 17 deaths, including three from ventilator disconnection. Life table analysis showed 1-year survival to be 84%, and 5-year survival 65%. Home mechanical ventilation, with patients cared for by family and friends, cost less (average less than $1000/mo) than registered nurse or hospital care (average $16,000/mo). There was no significant difference in the number of deaths between patients cared for by registered nurses 24 hours a day and those cared for by family and friends. Home mechanical ventilation may be a reasonably safe and cost-effective alternative to prolonged hospitalization for the ventilator-dependent child.
对54例慢性呼吸功能不全儿童进行家庭机械通气结果的回顾性研究。儿童年龄从4个月至18岁不等。33例患者采用气管切开术和正压通气，21例患者采用负压通气。9例患者最终脱机，其中包括3例四肢瘫痪患者，随后对其使用了膈神经电刺激。在20多年的时间里，有17例死亡，其中3例死于呼吸机脱开。生命表分析显示1年生存率为84%，5年生存率为65%。由家人和朋友照顾患者的家庭机械通气成本（平均每月不到1000美元）低于由注册护士或医院护理的成本（平均每月16000美元）。每天由注册护士护理的患者与由家人和朋友护理的患者之间的死亡人数没有显著差异。对于依赖呼吸机的儿童，家庭机械通气可能是一种合理安全且具有成本效益的替代长期住院治疗的方法。
