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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Liberation and mortality outcomes in pediatric long‐term ventilation: A qualitative systematic review
Pediatric pulmonology, v 55(11), pp 2853-2862
Nov 2020
PMID: 32741115
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective
To provide a systematic review of liberation from positive pressure ventilation and mortality of children with chronic respiratory failure who used long‐term invasive and noninvasive ventilation (LTV).
Methods
Papers published from 1980 to 2018 were identified using Pubmed MEDLINE, Ovid MEDLINE, Embase, and Cochrane databases. Search results were limited to English‐language papers with (a) patients less than 22 years at initiation, (b) patients who used invasive ventilation (IV) via tracheostomy or noninvasive ventilation (NIV), and (c) data on mortality or liberation from LTV. Data were presented using descriptive statistics; changes in outcomes over time were explored using linear regression. Follow‐up variability, cohort heterogeneity, and insufficient data precluded combining data to estimate incidences or rates.
Results
One hundred and thirty papers with 12 704 patients were included. The median number of patients was 37 (interquartile range [IQR] 17‐74, range 6‐3802). Twenty‐five percent of patients were initiated on IV; 75% on NIV. The maximum follow‐up ranged from 0.5 to 31.8 years (median 8.8 years). The median proportion of patients liberated in these papers was 3% (IQR 0%‐21%). The median proportion of mortality was 18% (IQR 8%‐27%). Proportions of liberation and mortality did not significantly change over time. Progression of underlying disease (44%), respiratory illness (19%), and LTV accident (11%) were the most common causes of death.
Conclusions
These papers collectively show most patients survive for many years using LTV; in many subgroups, death is a more common outcome than liberation. However, the limitations of these papers preclude robust prognostication.
Metrics
Details
- Title
- Liberation and mortality outcomes in pediatric long‐term ventilation: A qualitative systematic review
- Creators
- Candice M. Foy - Stony Brook University HospitalMonica L. Koncicki - St. Christopher's Hospital for ChildrenJeffrey D. Edwards - Columbia University
- Publication Details
- Pediatric pulmonology, v 55(11), pp 2853-2862
- Publisher
- Wiley
- Number of pages
- 10
- Grant note
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23 HD 082361)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000558528000001
- Scopus ID
- 2-s2.0-85089312654
- Other Identifier
- 991019167957304721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Pediatrics
- Respiratory System