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Mun, Kim, Kim, Park, Kim, Shin, and Son: A study of the use of home mechanical ventilator and medical insurance
Original Article

Allergy Asthma Respir Dis 2016;4(3):195-198.

Published online: 12 May 2016

DOI: https://doi.org/10.4168/aard.2016.4.3.195

A study of the use of home mechanical ventilator and medical insurance

Sang Wook Mun1, Hyung Young Kim1, Hye-Young Kim2, Hee Ju Park1, Soo Yeon Kim3, Young Beom Shin4, Seung Kook Son1

1Department of Pediatrics, Pusan National University Children's Hospital, Yangsan

2Department of Pediatrics, Pusan National University Hospital, Busan

3Department of Rehabilitation Medicine, Pusan National University School of Medicine, Yangsan

4Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, Korea

Correspondence to: Seung Kook Son http://orcid.org/0000-0002-4902-5351 Department of Pediatrics, Pusan National University Children's Hospital, 20 Geumo-ro, Meulgeum-eup, Yangsan 50612, Korea Tel: +82-55-360-2180, Fax: +82-55-360-2181, E-mail: sonofs@naver.com

Received 10 September 2015       Revised 12 October 2015       Accepted 12 October 2015

Copyright © 2016 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Use of a home mechanical ventilator can shorten the hospitalization duration of children with chronic respiratory failure requiring longterm use of a mechanical ventilator. In this study, the researchers analyzed patients who had used a home mechanical ventilator.

Methods

From January 2009 to July 2014, we retrospectively investigated 15 patients under 18 years of age, from 2 hospitals, and their use of home mechanical ventilators.

Results

The median age of the patients was 55 months. Ten children were male, and 5 were female. As for the type of mechanical ventilators, 10 used a pressure type, 3 used a volume type, and 2 used a volume-mask type. Analysis of underlying diseases revealed that 10 children had neuromuscular disease, 3 had pulmonary disease, and 2 suffered from hypoxic ischemic encephalopathy. The number of patients who were discharged from the hospital with a home mechanical ventilator was 13. One child died of sepsis irrespective of the mechanical ventilator. Six patients had health insurance. But 9 did not. The group with insurance had the possibility of being discharged earlier than the group without. On readmission, the length of hospitalization was also reduced in patients who had used a home mechanical ventilator.

Conclusion

Use of a mechanical ventilator at home is helpful in patients who need longterm use of a mechanical ventilator due to neuromuscular disease, chronic pulmonary diseases, and accidents because complications are rare and insurance coverage is feasible.(Allergy Asthma Respir Dis 2016;4:195–198)

Keywords: Mechanical ventilator, Home, Child

References

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Table 1.
Demographic characteristics of the patients applying home mechanical ventilator (n=15)
Characteristic Value
Male sex 10 (66.7)
Age of applying home mechanical ventilator (yr), median (IQR) 4.6 (1.2–14.0)
Tracheostomy 13 (86.7)
Mode of ventilator  
Pressure control–SIMV with tracheostomy 10 (66.7)
Volume control–SIMV with tracheostomy 3 (20.0)
Volume mask type without tracheostomy 2 (31.2)
Weaning from ventilator 2 (13.3)
Expired 1 (6.7)
Follow-up period from applying home ventilator (yr), mean (IQR) 2.2 (0.7–2.4)

Values are presented as number of patients (%) unless otherwise indicated. IQR, interquartile range; SIMV, synchronized intermittent mandatory ventilation.

Table 2.
Underlying disease of patients (n=15)
Disease No. of patients (%) Application of insurance
Neuromuscular disease 10 (66.7)  
Muscular dystrophy 4 (26.7) Y
Mitochondrial disease 3 (20.0) Y
Spinal muscular dystrophy 2 (13.3) Y
Metachromatic leukodystrophy 1 (6.7) N
Respiratory disease 3 (20.0)  
Chronic lung disease 2 (13.3) N
Asphyxating thoracic dysplasia 1 (6.7) N
HIE 2 (13.3) N

HIE, hypoxic ischemic encephalopathy.

Table 3.
Duration from tracheostomy to applying home mechanical ventilator according to insurance (n=13)
Group Duration (day), median (range) P-value
Insurance group (n=7) 30 (3–67) 0.035
Noninsurance group (n=6) 127 (23–868)  

Mann-Whitney test.

Table 4.
Duration of hospitalization depending on applying home mechanical ventilator
Group Home ventilato apply (day) P-value
Before After
Insurance group 113.6±155.7 11.2±21.7 0.008
Non insurance group 85.9±102.2 21.2±21.0 0.075
Total 102.5±133.3 15.2±21.2 0.002

Values are presented as mean±standard deviation. Wilcoxon signed rank test.

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