4.5 Review

Long-Term Ventilation in Children with Medical Complexity: A Challenging Issue

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CHILDREN-BASEL
卷 9, 期 11, 页码 -

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MDPI
DOI: 10.3390/children9111700

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children with medical complexity; continuous positive airway pressure; long-term invasive mechanical ventilation; sleep apnea syndrome; sleep-disordered breathing; palliative care; ethical issues

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This review examines the clinical indications and ethical considerations for the initiation, continuation, or withdrawal of long-term mechanical ventilation (LTMV) among children with medical complexity (CMCs). The decision should be based on clinical and ethical considerations and should involve the parents.
Children with medical complexity (CMCs) represent a subgroup of children who may have congenital or acquired multisystemic disease. CMCs are frequently predisposed to respiratory problems and often require long-term mechanical ventilation (LTMV). The indications for LTMV in CMCs are increasing, but gathering evidence about indications, titration, and monitoring is currently the most difficult challenge due to the absence of validated data. The aim of this review was to examine the clinical indications and ethical considerations for the initiation, continuation, or withdrawal of LTMV among CMCs. The decision to initiate long-term ventilation should always be based on clinical and ethical considerations and should be shared with the parents.

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