Sir.—I am a home care physician and read with much concern the report of late sudden unexpected deaths in infants with bronchopulmonary dysplasia who required prolonged mechanical ventilation.1 During the past decade, I have been discharging patients and helping families manage their ventilator-assisted children at home.2 These children were medically stable, as defined by clinical course (no major diagnostic intervention or therapeutic changes within 1 month) and by clinical and physiologic criteria appropriate to age and underlying pathogenesis.3
Cases of patients with bronchopulmonary dysplasia who require home mechanical ventilation are represented in my experiences both in Illinois and in Pennsylvania.3,4 Such patients have required months of optimal ventilation as defined by patient eligibility criteria,4 and these cases have resulted in excellent outcomes for children who grow and develop and eventually become free of their need for oxygen and the ventilator.
Home mechanical ventilation
GOLDBERG AI. Late Sudden Unexpected Deaths in Hospitalized Infants With Bronchopulmonary Dysplasia. Am J Dis Child. 1990;144(3):270. doi:10.1001/archpedi.1990.02150270016010