Abstract
Neonates requiring prolonged ventilator support and tracheostomy care are often confined to intensive care units for extended periods of time. With appropriate education for parents and caretakers, these patients can be managed at home while still requiring respiratory support. During the past 2½ years, we have discharged 9 infants on respiratory support. Mean birthweight was 1610 grams (range 750-4480 gms), mean age at time of discharge was 7.1 months (range 2-11 mos.). All patients had tracheostomies. At discharge, respiratory support consisted of mechanical ventilation in 2, CPAP in 3, and T-piece in 4. Inspired O2 concentration was 21% in all infants at time of discharge. Five infants required initial home nursing care, with a mean of 20.8 hours/day (range 8-24 hrs). Presently, these patients have been home for a mean of 15.7 months (range 1-29 mos). All nine patients have had elective readmissions, four have required staged tracheoplasty. Only two infants (both mechanically ventilated) have had emergency admissions for pneumonia. Three infants had intercurrent viral respiratory infections that required an increase in oxygen or ventilation at home for brief periods. At this time, four of nine patients have been successfully decannulated. Evaluation of this patient groups's needs has led us to an organized program for monitoring and follow-up of patients clinical progress. A six week schematic flow sheet is used to delegate responsibilities to the members of a multidisciplinary team working with patient and family. We believe this approach is appropriate for this patient population and represents an incurred care cost reduction for families and third party payers of 30-80%.
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Corcoran, L., Spitzer, A. & Fox, W. 1748 EARLY DISCHARGE FOR NEONATES REQUIRING CONTINUING RESPIRATORY CARE. Pediatr Res 19, 402 (1985). https://doi.org/10.1203/00006450-198504000-01766
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DOI: https://doi.org/10.1203/00006450-198504000-01766