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Multicenter Study
. 2004 May;30(5):918-25.
doi: 10.1007/s00134-004-2225-5. Epub 2004 Mar 17.

What is the daily practice of mechanical ventilation in pediatric intensive care units? A multicenter study

J A Farias  1 , F Frutos, A Esteban, J Casado Flores, A Retta, A Baltodano, I Alía, T Hatzis, F Olazarri, A Petros, M Johnson
Affiliations
Multicenter Study

What is the daily practice of mechanical ventilation in pediatric intensive care units? A multicenter study

J A Farias et al. Intensive Care Med. 2004 May.

Abstract

Objective: To describe the daily practice of mechanical ventilation (MV), and secondarily, its outcome in pediatric intensive care units (PICUs).

Design: Prospective cohort of infants and children who received MV for at least 12 h.

Setting: Thirty-six medical surgical PICUs.

Patients: All consecutive patients admitted to the PICUs during 2-month period.

Measurements and main results: Of the 1893 patients admitted, 659 (35%) received MV for a median time of 4 days (25th percentile, 75%: 2, 6). Median of age was 13 months (25th percentile, 75%: 5, 48). Common indications for MV were acute respiratory failure (ARF) in 72% of the patients, altered mental status in 14% of the patients, and ARF on chronic pulmonary disease in 10% of the patients. Median length of stay in the PICUs was 8 days (25th percentile, 75%: 5, 13). Overall mortality rate in the PICUs was 15% (confidence interval 95%: 13-18) for the entire population, 50% (95% CI: 25-74) in patients who received MV because of acute respiratory distress syndrome, 24% (95% CI: 16-35) in patients who received MV for altered mental status and 16% (95% CI: 9-29) in patients who received MV for ARF on chronic pulmonary disease.

Conclusion: One in every 3 patients admitted to the PICUs requires ventilatory support. The ARF was the most common reason for MV, and survival of unselected infants and children receiving MV for more than 12 h was 85%.

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Figures

Fig. 1
Fig. 1
Modes of mechanical ventilation used during study period. VLV-A/C volume limited ventilation—assist/control, SIMV synchronized intermittent mandatory ventilation, PCV pressure control ventilation, PSV pressure support ventilation, SIMV+PSV synchronized intermittent mandatory plus pressure support ventilation, HFOV high-frequency oscillatory ventilation
Fig. 2
Fig. 2
Modes of weaning used in 590 attempts. SIMV synchronized intermittent mandatory ventilation, PSV pressure support ventilation, SIMV+PSV synchronized intermittent mandatory plus pressure support ventilation, CPAP continuous positive airway pressure
See this image and copyright information in PMC

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