Care and Management of HMV Patients at Hospital

Home mechanically ventilated pediatric patients are a vulnerable population, and hospital admission is often necessary for acute or elective indications. The care of these patients at hospital raises unique challenges to the ICU or IMC team, which include competence in handling respiratory support devices used in HMV and taking care of a tracheostoma or many different noninvasive interfaces. In many respects, it is helpful to use the respiratory equipment and ventilator the patients use at home if possible. Therefore, the team has to be experienced in dealing with machines not usually used in the PICU. Further special needs of the patient arise through their often complex underlying diseases with multiple organ involvement. The majority of acute hospital admissions in HMV patients are due to respiratory complications. This chapter therefore focuses on respiratory issues when reviewing frequent causes of hospital admission but also some rare complications leading to emergency admissions and includes discussions on treatment.