We have located links that may give you full text access.
Journal Article
Review
Pediatric Prolonged Mechanical Ventilation: Considerations for Definitional Criteria.
Respiratory Care 2017 January
BACKGROUND: A 2005 consensus conference led by the National Association for Medical Direction of Respiratory Care (NAMDRC) defined prolonged mechanical ventilation (PMV) for adults as invasive and/or noninvasive mechanical ventilation (NIV) for ≥ 21 consecutive days for ≥ 6 h/d. In children, no such consensus definition exists. This results in substantial variability in definitional criteria, making study of the impact and outcomes of PMV across and within settings problematic. The objective of this work was to identify how PMV for children and neonates is described in the literature and to outline pediatric/neonatal considerations related to PMV, with the goal of proposing a pediatric/neonatal adaptation to the NAMDRC definition.
METHODS: We searched electronic databases for studies describing PMV in children. We extracted definitional criteria and developed recommendations based on the literature review and our clinical experience.
RESULTS: Of the 416 citations obtained, 87 met inclusion criteria, totaling 34,255 subjects. Identified criteria for the pediatric PMV definition included: number of consecutive days of mechanical ventilation (ranging from 6 h to 3 months), inclusion of NIV, time spent off the ventilator during weaning (considered as same ventilation episode), and importance of chronological age (term neonates) and postmenstrual age for preterm neonates. We considered high-flow nasal cannula; however, we determined that its current role as a weaning adjunct is unclear.
CONCLUSIONS: Therefore, we developed the following recommendations for the pediatric PMV definition: ≥ 21 consecutive days (after 37 weeks postmenstrual age) of ventilation for ≥ 6 h/d considering invasive ventilation and NIV and including short interruptions (< 48 h) of ventilation during the weaning process as the same episode of ventilation. We propose a definition of pediatric PMV that incorporates the number of consecutive days of mechanical ventilation while taking into account use of NIV and lung maturity and including short interruptions during the weaning process.
METHODS: We searched electronic databases for studies describing PMV in children. We extracted definitional criteria and developed recommendations based on the literature review and our clinical experience.
RESULTS: Of the 416 citations obtained, 87 met inclusion criteria, totaling 34,255 subjects. Identified criteria for the pediatric PMV definition included: number of consecutive days of mechanical ventilation (ranging from 6 h to 3 months), inclusion of NIV, time spent off the ventilator during weaning (considered as same ventilation episode), and importance of chronological age (term neonates) and postmenstrual age for preterm neonates. We considered high-flow nasal cannula; however, we determined that its current role as a weaning adjunct is unclear.
CONCLUSIONS: Therefore, we developed the following recommendations for the pediatric PMV definition: ≥ 21 consecutive days (after 37 weeks postmenstrual age) of ventilation for ≥ 6 h/d considering invasive ventilation and NIV and including short interruptions (< 48 h) of ventilation during the weaning process as the same episode of ventilation. We propose a definition of pediatric PMV that incorporates the number of consecutive days of mechanical ventilation while taking into account use of NIV and lung maturity and including short interruptions during the weaning process.
Full text links
Related Resources
Trending Papers
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Prevention and treatment of ischaemic and haemorrhagic stroke in people with diabetes mellitus: a focus on glucose control and comorbidities.Diabetologia 2024 April 17
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Eosinophilic Esophagitis: Clinical Pearls for Primary Care Providers and Gastroenterologists.Mayo Clinic Proceedings 2024 April
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app