Chronic Ventilatory Support for Children Following Trauma or Severe Neurologic Injury

Traumatic injuries are a leading cause of death and significant morbidity. Children who survive can suffer from respiratory failure and need for chronic ventilatory support. Care of children following trauma or severe neurologic injury includes providing for adequate ventilation, optimizing pulmonary care with airway clearance and prevention of recurrent pneumonias. There are several options for ventilatory support including positive pressure ventilation which is the most common, noninvasive positive pressure ventilation (NPPV) and diaphragm pacing. In this chapter, we review the pulmonary complications of trauma, the pathophysiology of respiratory failure, and the care of trauma survivors needing chronic assisted ventilation and respiratory care.