Late Breaking Abstract - Response of the paediatric Long Term Ventilation (LTV) department of Cambridge University Hospital (CUH) during the Covid-19 pandemic: challenges and lessons

Abstract

Introduction: The pandemic year brought significant disruption to NHS services, with reduced face to face appointments and hospital admissions.

Aim: Assess efficacy of adaptations made to continue and improve LTV service during the pandemic, with reference to recent NCEPOD report, providing guidance for the effective functionality of LTV teams.

Methods: Retrospective data collection (1/3/20-28/2/21) of patients on non-invasive ventilation (NIV), with tracheostomy in situ and tracheostomy ventilated and comparison with data from previous year (1/3/19-29/2/20).

Results: 82 patients, average age 7.5yo. Increased acute admissions at CUH noted, but reduction in ED presentations, GP visits, acute admissions at local hospitals and oral or IV antibiotics for chest exacerbations. 96.3% patients reviewed at least once via telephone and video appointments. Introduction of home sleep studies and reviews by community teams since May 2020 in 42 and 25 occasions retrospectively; remote guidance to alter ventilation settings for 8 patients. Inpatient sleep studies continued, as well as NIV initiation referrals for patients with conditions e.g., neuromuscular disorders, sleep disordered breathing and airway malacia. Personalized escalation plans implemented for 56.1% patients; physiotherapy plans and cough assist use doubled.

Conclusion: Despite challenges related to the pandemic, LTV department improvements made via use of technology and collaboration with community teams and other tertiary hospitals in EEA and London; reflected by positive patient feedback. Further planning for service development in line with NCEPOD report guidance.