Long-Term Home Noninvasive Ventilation Program in Children: 17 Years of Follow-Up From a Tertiary Center in Chile.

INTRODUCTION

Established in 2006, Chile's National Program of Noninvasive Mechanical Ventilation (NIV) provides continuous home ventilatory support.

OBJECTIVE

To provide an overview of the NIV Program in children and adolescents at a tertiary care center in Chile.

MATERIALS AND

METHODS

A retrospective study analyzed children in the NIV Program at a tertiary hospital from 2006 to 2023. We examined demographic characteristics, program duration, and respiratory, polygraphic, and gasometric variables, along with NIV initiation criteria. Statistical tests evaluated factors linked to program permanence, survival, and discharge outcomes. Data were divided into equal time periods for analysis.

RESULTS

A total of 113 children were included (median age: 8.3 years; IQR: 3.2-12.8). At the time of analysis, 51.3% continued in the program. The most common diagnoses were neuromuscular disease (NMD, 38.9%), central nervous system disorder (30.1%), and upper airway obstruction (14.2%). The age for NIV initiation was significantly lower in 2018-2020 compared to 2009-2011 (p < 0.05). The annual admission rate was 7.3 patients, with 3.1 discharges. The median program duration was 7 years (IQR: 5-11), varying by discharge reason (p < 0.001). Of the 55 discharged patients, 30.9% transitioned to adult care, 23.6% died, and 21.8% improved. The 5-year survival and ventilator discharge incidences were 88% and 67%, respectively. NIV was primarily initiated based on clinical (44%) and polygraphic (19%) criteria.

CONCLUSIONS

NMD was the most prevalent diagnosis at the start of NIV and the main condition linked to the transition to adult care. NIV initiation occurred earlier over time, with high 5-year survival rates.