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Review Article2018 Year in Review

Year in Review 2018: Pediatric Mechanical Ventilation

Craig D Smallwood and Michael D Davis
Respiratory Care July 2019, 64 (7) 855-863; DOI: https://doi.org/10.4187/respcare.07029
Craig D Smallwood
Division of Critical Care Medicine, Department of Anesthesia, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts.
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  • For correspondence: [email protected]
Michael D Davis
Division of Pulmonary Medicine; Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia.
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    Fig. 1.

    All pediatric ARDS PEEP-FIO2 combinations. Actual PEEP values as a function of actual FIO2 levels (median [bar] and interquartile range [box]) for all the subjects with pediatric ARDS for the first day of mechanical ventilation after a pediatric ARDS diagnosis. The superimposed line represents the ARDS Network protocol target combinations of PEEP-FIO2. In general, the clinicians used more PEEP than recommended when FIO2 was <0.4 and used less PEEP than recommended when FIO2 was >0.5. Median PEEP did not exceed 10 cm H2O, regardless of FIO2. From Reference 1, with permission.

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    Fig. 2.

    Comparison of increases in dynamic pulmonary compliance and oxygenation. Mean ± SD values are denoted by the circles and whiskers; δ (%) is the change in either oxygen saturation index (OSI) (OSI = FIO2 × P̄aw × 100/SpO2) or respiratory system compliance (CRS) relative to the maxima at each time point. A: Responders (those who had an increase in oxygenation after PEEP increase), OSI improved by 13% and CRS improved by 14% during the monitoring time frame in responders. B: Non-responders (no change in oxygenation or worsening after PEEP increase). From Reference 20, with permission.

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    Fig. 3.

    Bland-Altman plot for the McLaren-Read ideal body weight (IBW) method in male and female subjects ages 2–20 y. The center line denotes bias; outside lines show upper and lower limits. From Reference 26.

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Respiratory Care: 64 (7)
Respiratory Care
Vol. 64, Issue 7
1 Jul 2019
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Year in Review 2018: Pediatric Mechanical Ventilation
Craig D Smallwood, Michael D Davis
Respiratory Care Jul 2019, 64 (7) 855-863; DOI: 10.4187/respcare.07029

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Year in Review 2018: Pediatric Mechanical Ventilation
Craig D Smallwood, Michael D Davis
Respiratory Care Jul 2019, 64 (7) 855-863; DOI: 10.4187/respcare.07029
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  • Article
    • Abstract
    • Introduction
    • Pediatric ARDS
    • Sedation in the ICU and During Mechanical Ventilation
    • Ventilator Management
    • Ventilation at Home
    • Quality and Safety
    • Weaning and Liberation
    • Conclusions
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • References
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Cited By...

Keywords

  • ICU
  • mechanical ventilation
  • pediatrics
  • pediatric ARDS
  • neurally-adjusted ventilatory assist

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