Increasing numbers of children who depend on respiratory technology live and are cared for at home rather than in the hospital. Families’ and caregivers’ concern for developmental and psychosocial advantages and insurance companies’ concern for cost savings have motivated the shift to home care. Coincidental advances in technology have facilitated this change. Although a child’s need may be simple—perhaps just nocturnal oxygen—for many children, respiratory technology is only one aspect of a complicated,multi-faceted care plan.

This review describes our centers’ approaches to several aspects of chronic home therapy, including oxygen therapy,tracheostomy, and mechanical ventilation. Most of these approaches have not been studied critically, and the practices of various centers across the country may vary considerably.

Oxygen, usually delivered by nasal cannula, frequently is indicated to correct the hypoxemia of chronic lung diseases in childhood and, more rarely, that which is associated with resolving acute lung disease or obstructive sleep apnea....

You do not currently have access to this content.