Trends in Long-Term Ventilation Care in U.K. Children and Young People—Further Consideration Required for Pediatric Critical Care Services

Abstract

OBJECTIVES: The objective was to compare specific data from the 2020 National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report “Balancing the Pressures” with two previous U.K. studies and to examine changes in the pediatric population requiring long-term ventilation (LTV) as well as the types delivered. We believe that the new data presented will facilitate future service planning. DESIGN: A subset of confidential enquiry data derived from a study by a nationally funded quality improvement organization (NCEPOD: www.ncepod.org.uk) was compared with two previous U.K. datasets. SETTING: Healthcare providers across England, Wales, and Northern Ireland—inpatient and community settings. PATIENTS: Children and young people (CAYP) 0–16 years old receiving LTV between April 1, 2016, and March 31, 2018. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: When comparing the NCEPOD data with that last published in the United Kingdom, the number of CAYP requiring LTV more than doubled between 2008 and 2018 (933–2,093). There has also been a particular increase in the proportion of children that were under two when they were commenced on LTV (26–39.2%). Children are now more likely than previously to be receiving LTV to manage upper airway obstruction and CNS conditions. There has also been an approximate doubling of those receiving LTV over the whole 24-hour period (9.4–18.4%). CONCLUSIONS: The increased numbers and changing characteristics of babies and children requiring LTV over the last 3 decades in the United Kingdom have implications for all healthcare sectors but particularly for providers of critical care services.