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Article ; Online: Lived experiences of caregivers with infants treated at home with continuous invasive or noninvasive ventilation.

Maniaci, Jon / Kearney, Matthew D / DeMauro, Sara B / Panitch, Howard

2024

Abstract: Rationale: Caring for children dependent upon continuous invasive ventilation in the home setting requires extensive expertise, coordination, and can result in impaired caregiver quality of life. Less is known regarding the experiences of caregivers ... ...

Abstract	Rationale: Caring for children dependent upon continuous invasive ventilation in the home setting requires extensive expertise, coordination, and can result in impaired caregiver quality of life. Less is known regarding the experiences of caregivers with children requiring continuous noninvasive ventilation. Objectives: To evaluate caregiver experiences with invasive and noninvasive home mechanical ventilation, and to compare parental quality of life based on the child's mode of ventilation. Methods: Caregivers of infants who were discharged home with continuous ventilatory support were recruited to complete semi-structured qualitative interviews. Interviews explored their decision-making process, the transition to home, and health related quality of life. Results: Caregivers of 16 children were interviewed, of whom eight were treated with continuous invasive ventilation, and eight with continuous noninvasive ventilation. The decision to pursue home ventilation in both groups was greatly influenced by the desire to be discharged and reunite the family at home. Following the transition to home, caregivers from both groups described high rates of insomnia, emotional distress, work disruption and familial hardship. Despite this, parents were overwhelmingly pleased with the decision to proceed with home ventilation and perceived their children to be living enriched lives outside of the hospital. Factors associated with easing the transition to home were in-hospital training and the presence of a robust support system. Conclusions: Lives of families with children dependent on continuous mechanical ventilation are characterized by isolation, lifestyle disruption, adverse mental and physical health consequences, and impaired interpersonal relationships, irrespective of the mode of ventilation.
Language	English
Publishing date	2024-05-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	632784-9
ISSN	1099-0496 ; 8755-6863
ISSN (online)	1099-0496
ISSN	8755-6863
DOI	10.1002/ppul.27063
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Article ; Online: Respiratory Implications of Pediatric Neuromuscular Disease.

Panitch, Howard B

Respiratory care

2017 Volume 62, Issue 6, Page(s) 826–848

Abstract: Children with progressive neuromuscular weakness undergo a stereotypical progression of respiratory involvement, beginning with impaired airway clearance and progressing to nocturnal and then diurnal ventilatory failure. This review examines issues ... ...

Abstract	Children with progressive neuromuscular weakness undergo a stereotypical progression of respiratory involvement, beginning with impaired airway clearance and progressing to nocturnal and then diurnal ventilatory failure. This review examines issues related to airway clearance and mucus mobilization, sleep problems, and use of assisted ventilation in children with neuromuscular diseases. Interventions for each of these problems have been created or adapted for the pediatric population. The use of airway clearance therapies and assisted ventilation have improved survival of children with neuromuscular weakness. Questions regarding the best time to introduce some therapies, the therapeutic utility of certain interventions, and the cost-effectiveness of various treatments demand further investigation. Studies that assess the potential to improve quality of life and reduce hospitalizations and frequency of lower-respiratory tract infections will help clinicians to decide which techniques are best suited for use in children. As children with neuromuscular disease survive longer, coordinated programs for transitioning these patients to adult care must be developed to enhance their quality of life.
Language	English
Publishing date	2017-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	603252-7
ISSN	1943-3654 ; 0098-9142 ; 0020-1324
ISSN (online)	1943-3654
ISSN	0098-9142 ; 0020-1324
DOI	10.4187/respcare.05250
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Article ; Online: Rebuttal From Dr Panitch.

Panitch, Howard B

Chest

2016 Volume 151, Issue 5, Page(s) 969–970

MeSH term(s)	Humans ; Infant ; Muscular Atrophy, Spinal ; Noninvasive Ventilation ; Respiration
Language	English
Publishing date	2016-12-15
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1016/j.chest.2016.11.040
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Article ; Online: COUNTERPOINT: Is Noninvasive Ventilation Always the Most Appropriate Manner of Long-term Ventilation for Infants With Spinal Muscular Atrophy Type 1? No.

Panitch, Howard B

Chest

2016 Volume 151, Issue 5, Page(s) 965–968

MeSH term(s)	Child, Preschool ; Humans ; Infant ; Noninvasive Ventilation/adverse effects ; Noninvasive Ventilation/methods ; Spinal Muscular Atrophies of Childhood/mortality ; Spinal Muscular Atrophies of Childhood/therapy ; Survival Rate ; Tracheostomy/adverse effects ; Tracheostomy/methods
Language	English
Publishing date	2016-12-15
Publishing country	United States
Document type	Editorial
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1016/j.chest.2016.11.039
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Article ; Online: Transitioning from an ICU ventilator to a portable home ventilator.

Fierro, Julie L / Panitch, Howard B

Seminars in fetal & neonatal medicine

2019 Volume 24, Issue 5, Page(s) 101041

Abstract: There is a variety of portable ventilators on the market, each with its' own features. A clinician needs to understand the unique characteristics of the ventilators available in his or her region, as well as the nuances of primary and secondary settings ... ...

Abstract	There is a variety of portable ventilators on the market, each with its' own features. A clinician needs to understand the unique characteristics of the ventilators available in his or her region, as well as the nuances of primary and secondary settings for these portable home ventilators in order to create a comfortable breath that allows for adequate gas exchange for the patient. Understanding the interplay of the portable home ventilator and the ventilator circuit is also a key component of transitioning a patient to a portable home ventilator. This review details characteristics of some of the more commonly used machines in the United States, as well as the settings to be considered in supporting a child with chronic respiratory failure outside of the hospital. As more patients are being discharged from the hospital with mechanical home ventilation, new ventilators are being developed that expand upon features of current machines.
MeSH term(s)	Electric Power Supplies ; Female ; Home Care Services/organization & administration ; Home Care Services, Hospital-Based/organization & administration ; Humans ; Infant Care/methods ; Infant Care/organization & administration ; Infant, Newborn ; Intensive Care Units ; Male ; Respiration, Artificial/methods ; Transitional Care/organization & administration ; United States
Language	English
Publishing date	2019-10-15
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2174416-6
ISSN	1878-0946 ; 1744-165X
ISSN (online)	1878-0946
ISSN	1744-165X
DOI	10.1016/j.siny.2019.101041
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Article ; Online: Pulmonary complications of abdominal wall defects.

Panitch, Howard B

Paediatric respiratory reviews

2015 Volume 16, Issue 1, Page(s) 11–17

Abstract: The abdominal wall is an integral component of the chest wall. Defects in the ventral abdominal wall alter respiratory mechanics and can impair diaphragm function. Congenital abdominal wall defects also are associated with abnormalities in lung growth ... ...

Abstract	The abdominal wall is an integral component of the chest wall. Defects in the ventral abdominal wall alter respiratory mechanics and can impair diaphragm function. Congenital abdominal wall defects also are associated with abnormalities in lung growth and development that lead to pulmonary hypoplasia, pulmonary hypertension, and alterations in thoracic cage formation. Although infants with ventral abdominal wall defects can experience life-threatening pulmonary complications, older children typically experience a more benign respiratory course. Studies of lung and chest wall function in older children and adolescents with congenital abdominal wall defects are few; such investigations could provide strategies for improved respiratory performance, avoidance of respiratory morbidity, and enhanced exercise ability for these children.
MeSH term(s)	Abdominal Wall/abnormalities ; Adolescent ; Child ; Child, Preschool ; Gastroschisis/complications ; Hernia, Abdominal/complications ; Humans ; Infant ; Infant, Newborn ; Lung/physiopathology ; Lung Diseases/etiology ; Respiratory Function Tests
Language	English
Publishing date	2015-01
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2147664-0
ISSN	1526-0550 ; 1526-0542
ISSN (online)	1526-0550
ISSN	1526-0542
DOI	10.1016/j.prrv.2014.10.004
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Article ; Online: Pediatric Simulation of Intrinsic PEEP and Patient-Ventilator Trigger Asynchrony During Mechanical Ventilation.

Nickel, Amanda J / Panitch, Howard B / McDonough, Joseph M / Chotzoglou, Etze / Allen, Julian L

Respiratory care

2022 Volume 67, Issue 11, Page(s) 1405–1412

Abstract: Background: Intrinsic PEEP during mechanical ventilation occurs when there is insufficient time for expiration to functional residual capacity before the next inspiration, resulting in air trapping. Increased expiratory resistance (R: Methods: Using ... ...

Abstract	Background: Intrinsic PEEP during mechanical ventilation occurs when there is insufficient time for expiration to functional residual capacity before the next inspiration, resulting in air trapping. Increased expiratory resistance (R Methods: Using a Servo lung model (ASL 5000) and LTV 1200 ventilator in pressure control mode, we developed a passive model demonstrating how elevated R Results: Intrinsic PEEP increased significantly with increasing R Conclusions: A passive lung model describes the development of increasing intrinsic PEEP with increasing R
MeSH term(s)	Child ; Humans ; Exhalation ; Lung ; Positive-Pressure Respiration, Intrinsic ; Respiration, Artificial/methods ; Ventilators, Mechanical
Language	English
Publishing date	2022-09-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	603252-7
ISSN	1943-3654 ; 0098-9142 ; 0020-1324
ISSN (online)	1943-3654
ISSN	0098-9142 ; 0020-1324
DOI	10.4187/respcare.09484
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Article ; Online: Pulmonary Manifestations of Congenital Heart Disease in Children.

Johnson, Brandy N / Fierro, Julie L / Panitch, Howard B

Pediatric clinics of North America

2020 Volume 68, Issue 1, Page(s) 25–40

Abstract: This review addresses how anomalous cardiovascular anatomy imparts consequences to the airway, respiratory system mechanics, pulmonary vascular system, and lymphatic system. Abnormal formation or enlargement of great vessels can compress airways and ... ...

Abstract	This review addresses how anomalous cardiovascular anatomy imparts consequences to the airway, respiratory system mechanics, pulmonary vascular system, and lymphatic system. Abnormal formation or enlargement of great vessels can compress airways and cause large and small airway obstructions. Alterations in pulmonary blood flow associated with congenital heart disease (CHD) can cause abnormalities in pulmonary mechanics and limitation of exercise. CHD can lead to pulmonary arterial hypertension. Lymphatic abnormalities associated with CHD can cause pulmonary edema, chylothorax, or plastic bronchitis. Understanding how the cardiovascular system has an impact on pulmonary growth and function can help determine options and timing of intervention.
MeSH term(s)	Child ; Heart Defects, Congenital/complications ; Humans ; Lymphatic Abnormalities/etiology ; Lymphatic Abnormalities/physiopathology ; Pulmonary Circulation/physiology ; Respiratory Tract Diseases/etiology ; Respiratory Tract Diseases/physiopathology
Language	English
Publishing date	2020-12-23
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	215711-1
ISSN	1557-8240 ; 0031-3955
ISSN (online)	1557-8240
ISSN	0031-3955
DOI	10.1016/j.pcl.2020.09.001
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Article ; Online: Transition of patients with neuromuscular disease and chronic ventilator-dependent respiratory failure from pediatric to adult pulmonary care.

Cheng, Pi Chun / Panitch, Howard B / Hansen-Flaschen, John

Paediatric respiratory reviews

2019 Volume 33, Page(s) 3–8

Abstract: Improvements in medical care have allowed many children with neuromuscular disease and chronic respiratory failure to survive into adulthood. There are currently no published guidelines to facilitate transition from pediatric to adult respiratory care in ...

Abstract	Improvements in medical care have allowed many children with neuromuscular disease and chronic respiratory failure to survive into adulthood. There are currently no published guidelines to facilitate transition from pediatric to adult respiratory care in this population. The transition process in neuromuscular disease and chronic respiratory failure is uniquely challenging in that the patients are often declining in health and losing independence as they approach adulthood. Barriers to transition include lack of access to adult providers, incompatible health insurance, loss of resources within patients' medical structures, absence of transition preparation, and patient and family insecurity with a new healthcare system. The six core elements and optimal time frame of transition should be applied, with special consideration of the psychosocial aspects associated with neuromuscular disease. Successful transition revolves around information, open communication between young adults and their medical care team, and individualized planning to ensure optimal health and quality of life.
MeSH term(s)	Cerebral Palsy/complications ; Cerebral Palsy/therapy ; Family ; Health Services ; Health Services Accessibility ; Hospitals, Pediatric/organization & administration ; Humans ; Insurance, Health ; Muscular Dystrophy, Duchenne/complications ; Muscular Dystrophy, Duchenne/therapy ; Neuromuscular Diseases/complications ; Neuromuscular Diseases/therapy ; Noninvasive Ventilation ; Organizational Policy ; Patient Care Planning ; Pulmonary Medicine/methods ; Pulmonary Medicine/organization & administration ; Respiration, Artificial ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/therapy ; Spinal Cord Injuries/complications ; Spinal Cord Injuries/therapy ; Spinal Muscular Atrophies of Childhood/complications ; Spinal Muscular Atrophies of Childhood/therapy ; Tracheostomy ; Transition to Adult Care/organization & administration
Language	English
Publishing date	2019-04-05
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2147664-0
ISSN	1526-0550 ; 1526-0542
ISSN (online)	1526-0550
ISSN	1526-0542
DOI	10.1016/j.prrv.2019.03.005
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Article ; Online: Paediatric Tracheomalacia.

Hysinger, Erik B / Panitch, Howard B

Paediatric respiratory reviews

2016 Volume 17, Page(s) 9–15

Abstract: Intrathoracic tracheomalacia is characterized by increased compliance of the central airway within the thorax. This leads to excessive dynamic collapse during exhalation or periods of increased intrathoracic pressure such as crying. Extrathoracic ... ...

Abstract	Intrathoracic tracheomalacia is characterized by increased compliance of the central airway within the thorax. This leads to excessive dynamic collapse during exhalation or periods of increased intrathoracic pressure such as crying. Extrathoracic tracheomalacia involves dynamic collapse of the airway between the glottis and sternal notch that occurs during inhalation rather than exhalation. The tone of the posterior membrane of the trachea increases throughout development and childhood, as does the rigidity of the tracheal cartilage. Abnormalities of airway maturation result in congenital tracheomalacia. Acquired tracheomalacia occurs in the normally developed trachea due to trauma, external compression, or airway inflammation. Although tracheomalacia can be suspected by history, physical examination, and supportive radiographic findings, flexible fiberoptic bronchoscopy remains the "gold standard" for diagnosis. Current treatment strategies involve pharmacotherapy with cholinergic agents, positive pressure ventilation, and surgical repair.
MeSH term(s)	Bronchoscopy ; Cholinergic Agents/therapeutic use ; Humans ; Positive-Pressure Respiration ; Tracheobronchomalacia/diagnosis ; Tracheobronchomalacia/embryology ; Tracheobronchomalacia/therapy ; Tracheomalacia/diagnosis ; Tracheomalacia/embryology ; Tracheomalacia/therapy
Chemical Substances	Cholinergic Agents
Language	English
Publishing date	2016-01
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2147664-0
ISSN	1526-0550 ; 1526-0542
ISSN (online)	1526-0550
ISSN	1526-0542
DOI	10.1016/j.prrv.2015.03.002
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