Consensus Statements

Mechanical Ventilation: Beyond the ICU
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Support Systems

Long-term ventilation of infants and young children requires in support:

• Ventilator alarms for power failure and malfunction
• Secondary or backup ventilators
• DME provider of regular and 24-h emergency service
• Supplemental oxygen as indicated by medical necessity and physiologic monitoring
• Nutritional support
• Safe method of automobile transportation of the child and equipment
• Developmental support

Caregivers

Prior to discharge of the child from the hospital, all caregivers in home and community must become familiar with all aspects of the child's long-term care. All caregivers in the home must be trained in surveillance and be able to recognize and address indications of medical problems or equipment failure.

Ethical Issues

Patients have the right to choose whether to institute and continue, or withhold and withdraw, long-term ventilatory assistance. The physician is responsible for educating the patient and family so an informed decision can be made. The use of advance directives is encouraged.

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