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Clinical Findings and Resource Use of Infants and Toddlers Dependent on Oxygen and Ventilators

Franciscan Children's Hospital and Rehabilitation Center, 30 Warren Street, Boston, MA 02135

Helene M. Dumas, MS

The Research Center for Children with Special Health Care Needs, Franciscan Children's Hospital and Rehabilitation Center, Boston, MA

Stephen M. Haley, PhD

Center for Rehabilitation Effectiveness, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA

Margaret E. O'Neil, PhD

Department of Rehabilitation Sciences, MCP Hahnemann University, Philadelphia, PA

Margaret Renn

The Research Center for Children with Special Health Care Needs, Franciscan Children's Hospital

Teresa E. Bartolacci, MS

Rusk Institute of Rehabilitation Medicine, New York University Medical Center

Virginia Kharasch, MD

Department of Pulmonology, Franciscan Children's Hospital

Medical records were reviewed to describe characteristics, report clinical and resource measures, and determine if differences exist between the diagnostic groups of prematurity and multiple congenital anomalies/neurologic conditions for initial admissions of 37 infants and toddlers to an inpatient pulmonary rehabilitation program. More than 75% of the children had a tracheostomy at admission and discharge. Forty-six percent of the sample was admitted requiring only oxygen, whereas 51% were discharged requiring only oxygen and not mechanical ventilation. Thirty percent of the children weaned to a less invasive mode of ventilation while just under half of the children were discharged home. Between-group comparisons indicated statistically significant differences for nutritional support at discharge (p < = 0.05) and discharge disposition (P = 0.04). Complete weaning of oxygen or ventilator support during an initial inpatient pulmonary rehabilitation admission occurred less frequently than weaning to a less invasive mode of ventilation. This is an important consideration for referring children to rehabilitation programs, for clinical program improvement activities, and for setting realistic expectations for referral sources, patients and families, clinical staff, and payers. Further study is recommended using clinical data in program planning, in program improvements, and for setting outcome expectations for infants and toddlers dependent on pulmonary technology.

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