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Chronic respiratory failure (CRF) can be defined as the need for mechanical ventilatory support for at least 4 hours per day for a month or longer.1  The concept of supporting patients with CRF at home arose during the polio epidemics of the late 1940s and early 1950s, both because of the numbers of patients versus the number of available acute care beds and the desire of families to have their loved ones home.

The medical indications for chronic ventilatory support have shifted over time. In the 1970s and 1980s, the group of children with CRF comprised infants with chronic...

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