Benscoter, Dan

Advances in neonatal care have led to increased survival of infants with complex medical needs and technology dependence. Transition of the ventilator-dependent infant from hospital to home is a complex process that requires extensive coordination between the medical team and family. Home caregivers must be prepared to provide routine care for the ventilator-dependent child and respond to life-threatening emergencies. Families should be counseled on the need for home nursing, medical equipment and an adequate home environment to ensure a safe transition to home.

An abstract of a study by Thienprayoon et al understanding the long-term implications and decision-making complexities surrounding tracheostomy placement and permanent mechanical ventilation, including caregiver burden of tracheostomy care and potential for limited community resources is presented. The decision to place a tracheostomy tube in a child who will be ventilator-dependent for the duration of her life is complex.