Care alternatives for pediatric chronic mechanical ventilation [Alternativas de tratamento para pacientes pediátricos em ventilação mecânica crônica]

Objective: to determine the impact of transferring a pediatric population to mechanical ventilator dependency units (mvdus) or to home mechanical ventilation (hmv) on bed availability in the pediatric intensive care unit (icu). methods: this is a longitudinal,retrospective study of hospitalized children who required prolonged mechanical ventilation at the mvdu located at the hospital auxiliar de suzano,a secondary public hospital in são paulo,brazil. we calculated the number of days patients spent at mvdu and on hmv,and analyzed their survival rates with kaplan-meier estimator. results: forty-one patients were admitted to the mvdu in 7.3 years. median length of stay in this unit was 239 days (interquartile range = 102-479). of these patients,22 came from the icu,where their transfer made available 8,643 bed-days (a mean of 14 new patients per month). hmv of eight patients made 4,022 bed-days available in the hospital in 4 years (a mean of 12 new patients per month in the icu). survival rates of patients at home were not significantly different from those observed in hospitalized patients. conclusion: a hospital unit for mechanical ventilator-dependent patients and hmv can improve bed availability in icus. survival rates of patients who receive hmv are not significantly different from those of patients who remain hospitalized. copyright © 2011 by sociedade brasileira de pediatria.