Prolonged Hospitalization Due to Chronic Respiratory Diseases

Abstract

Advances in neonate and pediatric units have increased the survival rate of seriously ill children that are in need of chronic multidisciplinary care. A great proportion of them are those who depend on mechanical ventilation, because they are hospitalized for long periods of time in specialized units. This has made the existence of step-down units or long-stay hospitals much more necessary, before a discharge home plan is implemented. The main objective of chronic hospitalization is the transition from critical care units to home care, allowing the stabilization of the patient, setting for the best therapeutic ventilator approach, education for the family, preparing the patient for his own environment in addition to restoring swallowing, phonation, and respiratory musculature. For a comprehensive approach a multidisciplinary team should consider several health professionals: pediatric pulmonologist, nurse, physiotherapist, nutritional physician, speech pathologist, and psychologist. Progression will be determined by many clinical variables. Discharge must be planned from the beginning, always aiming to reach home care. A coordinated plan between medical teams at the hospital and at home is required.