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Advances in mechanical ventilation in children


Authors: M. Fedora
Published in: Anest. intenziv. Med., 19, 2008, č. 1, s. 16-18
Category: Intensive Medicine

Overview

Mechanical ventilation is a common intervention provided in paediatric intensive care units. The management of mechanical ventilation in paediatrics is guided by a limited number of paediatric trials along with the application of adult data. Mechanical ventilation with pressure limitation and low tidal volume has become customary in paediatric intensive care. High frequency oscillatory ventilation is considered a suitable method to ‘open the lung’ and certainly is a lung-protective approach. Further research of noninvasive ventilation, prone positioning, the surfactant and weaning support to assist the paediatric intensivists in the application of these therapies is warranted.

Keywords:
children – mechanical ventilation


Sources

1. Randolph, A. G., Meert, K. L., O’Neil, M. E. et al. The feasibility of conducting clinical trials in infants and children with acute respiratory failure. Am. J. Respir.Crit. Care Med., 2003, 167, p. 1334–1340.

2. Turner, D. A., Arnold, J. H. Insights in pediatric ventilation: timing of intubation, ventilatory strategies, and weaning. Current

Opinion in Critical Care, 2007, 13, p. 57–63.

3. Piastra, M., Antonelli, M., Caresta, E. et al. Noninvasive ventilation in childhood acute neuromuscular respiratory failure:

a pilot study. Respiration, 2006, 16 (Epub ahead of print).

4. Essouri, S., Nicot, F., Clement, A. et al. Noninvasive positive pressure ventilation in infants with upper airway obstruction:

comparison of continuous and bilevel positive pressure. Intensive Care Med., 2005, 31, p. 574–580.

5. Carroll, C. L., Schramm, C. M. Noninvasive positive pressure ventilation for the treatment of status asthmaticus in children.

Ann. Allergy Asthma Immunol., 2006, 96, p. 454–459.

6. Madden, B. P., Kariyawasam, H., Siddiqi, A. J. et al. Non- invasive ventilation in cystic fibrosis patients with acute or chronic

respiratory failure. Eur. Respir. J., 2002, 19, p. 310– 313.

7. Villar, J., Kacmarek, R. M., Perez-Mendez, L. et al. A high positive endexpiratory pressure, low tidal volume ventilatory

strategy improves outcome in persistent acute respiratory distress syndrome: a randomized, controlled trial.Crit. Care

Med., 2006, 34, p. 1311–1318.

8. Arnold, J. H., Hanson, J. H., Toro-Figuero, L. O. et al. Prospective, randomized comparison of high-frequency oscillatory

ventilation and conventional mechanical ventilation in pediatric respiratory failure.Crit. Care Med., 1994, 22,

p. 1530–1539.

9. Mehta, S., Granton. J,, MacDonald, R. J. et al. High-frequency oscillatory ventilation in adults: the Toronto experience.

Chest, 2004, 126, p. 518–527.

10. Dani, C., Bertini, G., Pezzati, M. et al. Effects of pressure support ventilation plus volume guarantee vs high-frequency oscillatory

ventilation on lung inflammation in preterm infants. Pediatr. Pulmonol., 2006, 41, p. 242–249.

11. Jaballah, N. B., Khaldi, A., Mnif, K. et al. High-frequency oscillatory ventilation in pediatric patients with acute respiratory

failure. Pediatr. Crit. Care Med., 2006, 7, p. 362–367.

12. Curley, M. A., Hibberd, P. L., Fineman, L. D. et al. Effect of prone positioning on clinical outcomes in children with acute lung injury: a randomized controlled trial. JAMA, 2005, 294, p. 229–237.

13. Mancebo, J., Fernandez, R., Blanch, L. et al. A multicenter trial of prolonged prone ventilation in severe acute respiratory

distress syndrome. Am. J. Respir.Crit. Care Med., 2006, 173, p. 1233–1239.

14. Spragg, R. G., Lewis, J. F., Walmrath, H. D. et al. Effect of recombinant surfactant protein C-based surfactant on the acute

respiratory distress syndrome. N. Engl. J. Med., 2004, 351, p. 884–892.

15. Willson, D. F., Thomas, N. J., Markovitz, B. P. et al. Effect of exogenous surfactant (calfactant) in pediatric acute lung injury:

a randomized controlled trial. JAMA, 2005, 293, p. 470–476.

16. Randolph, A. G., Wypij, D., Venkataraman, S. T. et al. Effect of mechanical ventilator weaning protocols on respiratory

outcomes in infants and children: a randomized controlled trial. JAMA, 2002, 288, p. 2561–2568.

17. Schultz, T. R., Lin, R. J., Watzman, H. M. et al.Weaning children from mechanical ventilation: a prospective randomized trial

of protocol-directed versus physician-directed weaning. Respir. Care, 2001, 46, p. 772–782.

18. Restrepo, R. D., Fortenberry, J. D., Spainhour, C. et al. Protocol- driven ventilator management in children: comparison

to nonprotocol care. J. Intensive Care Med., 2004, 19, p. 274–284.

19. Baisch, S. D., Wheeler, W. B., Kurachek, S. C. et al. Extubation failure in pediatric intensive care incidence and outcomes.

Pediatr. Crit. Care Med., 2005, 6, p. 312–318.

20. Fontela, P. S., Piva, J. P., Garcia, P. C. et al. Risk factors for extubation failure in mechanically ventilated pediatric patients.

Pediatr. Crit. Care Med., 2005, 6, p. 166–170.

21. Randolph, A. G., Forbes, P. W., Gedeit, R. G. et al. Cumulative fluid intake minus output is not associated with ventilator

weaning duration or extubation outcomes in children. Pediatr. Crit. Care Med., 2005, 6, p. 642–647.

22. Foland, J. A., Super, D. M., Dahdah, N. S. et al. The use of

the air leak test and corticosteroids in intubated children: a survey of pediatric critical care fellowship directors. Respir. Care, 2002, 47, p. 662–666.

23. Mhanna, M. J., Zamel, Y. B., Tichy, C. M. et al. The ‘air leak’ test around the endotracheal tube, as a predictor of postextubation

stridor, is age dependent in children. Crit. Care Med., 2002, 30, p. 2639–2643.

24. Suominen, P., Taivainen, T., Tuominen, N. et al. Optimally fitted trachea tubes decrease the probability of postextubation

adverse events in children undergoing general anesthesia. Paediatr. Anaesth., 2006, 16, p. 641–647.

25. Lukkassen, I. M., Hassing, M. B., Markhorst, D. G. Dexamethasone reduces reintubation rate due to postextubation

stridor in a high-risk paediatric population. Acta Paediatr., 2006, 95, p. 74–76.

26. Cheng, K. C., Hou, C. C., Huang, H. C. et al. Intravenous injection of methylprednisolone reduces the incidence of postextubation stridor in intensive care unit patients. Crit. Care Med., 2006, 34, p. 1345–1350.

Labels
Anaesthesiology, Resuscitation and Inten Intensive Care Medicine
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