Mechanical ventilation in pediatrics

Current Opinion in Critical Care

Volumn 6, Issue 1, 2000, Pages 66-70

  Bohn, Desmond ^a,b  

^a UNIVERSITY OF TORONTO   (Canada)

^b HOSPITAL FOR SICK CHILDREN   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

LUNG SURFACTANT; NITRIC OXIDE; STEROID;

ACUTE RESPIRATORY FAILURE; ARTIFICIAL VENTILATION; CHILD; HUMAN; PREMATURITY; REVIEW; STEROID THERAPY; SURGICAL TECHNIQUE; SURVIVAL RATE; TREATMENT OUTCOME;

EID: 0033928176     PISSN: 10705295     EISSN: None     Source Type: Journal    
DOI: 10.1097/00075198-200002000-00009     Document Type: Review

References (33)

1. 1 Wung JT, James LS, Kilchewskey E, James E: Management of infants with severe respiratory failure and persistence of the foetal circulation without hyperventilation. Pediatrics 1985, 76:488-494.
2. 2 Gerstmann DR, Minton SD, Stoddard RA, Meredith KS, Monaco F, Bertrand JM, et al.: The Provo multicenter early high-frequency oscillatory ventilation trial: Improved pulmonary and clinical outcome in respiratory distress syndrome. Pediatrics 1996, 98:1044-1057.
3. 3 Clark RH, Gerstmann DR, Null DM, deLemos RA: Prospective randomised comparison of high-frequency oscillatory and conventional ventilation in respiratory distress syndrome. Pediatrics 1992, 89:5-12.
4. 4 HiFo Study Group: Randomised study of high-frequency oscillatory ventilation in infants with severe respiratory distress syndrome. J Pediatr 1993, 122:609-619.
5. 5 Ogawa Y, Miyasaka K, Kawano T, Imura S, Inukai K, Okuyama K, et al.: A multicentre randomised trial of high frequency oscillatory ventilation as compared with conventional ventilation in preterm infants with respiratory failure. Early Hum Develop 1993, 32:1-10.
6. 6 Rettwitz-Volk W, Veldman A, Roth B, Vierzig A, Kachel W, Varaholt V, et al.: A prospective, randomized, multicenter trial of high-frequency oscillatory ventilation compared with conventional ventilation in preterm infants with respiratory distress syndrome receiving surfactant. J Pediatr 1998, 132:249-254.
7. 7 HiFi Study Group: High-frequency oscillatory ventilation compared with conventional mechanical ventilation in the treatment of respiratory failure in preterm infants. N Engl J Med 1989, 320:88-93.
8. 8 Thome U, Topfer A, Schaller P, Pohlandt F: Effects of mean airway pressure on lung vofume during high-frequency oscillatory ventilation of preterm infants. Am J Respir Crit Care Med 1998, 157:1213-1218. The first human study to measure lung volume changes on HFOV that demonstrates that lung volume recruitment is both time and mean airway pressure dependent.
9. 9 Thome U, Gotze-Speer B, Speer CP, Pohlandt F: Comparison of pulmonary inflammatory mediators in preterm infants treated with intermittent positive pressure ventilation or high frequency oscillatory ventilation. Pediatr Res 1998, 44:330-337. Highlights the importance of not assuming that the lung lavage model is not an exact paradigm for lung disease of prematurity. The use of HFOV in the lung lavage model is associated with decreased cytokine production by the lung (Imai Y, et al.: Am J Respir Crit Care Med 1994, 150:1550-1554.), whereas this human study failed to demonstrate a similar effect.
10. 10 Thome U, Kossel H, Lipowsky G, Porz F, Furste HO, Genzel-Boroviczeny O, et al.: Randomized comparison of high-frequency ventilation with high-rate intermittent positive pressure ventilation in preterm infants with respiratory failure. J Pediatr 1999, 135:39-46. Another negative (inconclusive) HFOV study that really compares this technique with a "standard" neonatal technique of high rate low tidal volume ventilation.
11. 11 Bjorklund JJ, Ingimarsson J, Curstedt T, et al.: Manual ventilation with a few large breaths at birth compromises the therapeutic effect of subsequent surfactant replacement in immature lambs. Pediatr Res 1997, 42:348-355.
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13. 13 Merritt TA, Cochrane CG, Holcomb K, Bohl B, Hallman M, Strayer D, et al.: Elastase and alpha 1-proteinase inhibitor activity in tracheal aspirates during respiratory distress syndrome: role of inflammation in the pathogenesis of bronchopulmonary dysplasia. J Clin Invest 1983, 72:656-666.
14. 14 Garland JS, Alex CP, Pauly TH, Whitehead VL, Brand J, Winston JF, et al.: A three-day course of dexamethasone therapy to prevent chronic lung disease in ventilated neonates: a randomized trial. Pediatrics 1999, 104:91-99.
15. 15 Kothadia JM, O'Shea TM, Roberts D, Auringer ST, Weaver RG III, Dillard RG: Randomized placebo-controlled trial of a 42-day tapering course of dexamethasone to reduce the duration of ventilator dependency in very low birth weight infants. Pediatrics 1999, 104:22-27. Two further studies demonstrating the potential role for steroids in chronic lung disease of prematurity. The ideal dosing remains elusive.
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18. 20 may improve survival in pediatric acute respiratory failure [abstract]. Am J Respir Crit Care Med 1995, 151:A77.
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20. 20 Ranieri VM, Suter PM, Tortorella C, et al.: Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome: A randomized controlled trial. JAMA 1999, 282:54-61. An important adult study that has implications for all age groups as it shows that pressure limited, reduced tidal volume ventilation with PEEP set above the inflection point can reduce the cytokine production from the lung and has the potential to change outcome in patients with ARDS and multiple-organ dysfunction syndrome.
21. 21 Rubenfeld GD, Crawford SW: Withdrawing life support from mechanically ventilated recipients of bone marrow transplants: a case for evidence-based guidelines. Ann Intern Med 1996, 125:625-633.
22. 22 Price KJ, Thall PF, Kish SK, Shannon VR, Andersson BS: Prognostic indicators for blood and marrow transplant patients admitted to an intensive care unit. Am J Respir Crit Care Med 1998, 158:876-884.
23. 23 Hayes C, Lush RJ, Cornish JM, et al.: The outcome of children requiring admission to an intensive care unit following bone marrow transplantation. Br J Haematol 1998, 102:666-670.
24. 24 Diaz de Heredia C, Moreno A, Olive T, Iglesias J, Ortega JJ: Tole of the intensive care unit in children undergoing bone marrow transplantation with life-threatening complications. Bone Marrow Transplant 1999, 24:163-168.
25. 25 Rossi R, Shemie SD, Calderwood S: Prognosis of pediatric bone marrow transplant recipients requiring mechanical ventilation. Crit Care Med 1999, 27:1181-1186. This study shows that the outcome in pediatric immonosuppressed patients with ARDS and multiple-organ dysfunction syndrome is much better than previous series have reported, perhaps due to a change in ventilation practices.
26. 26 Willson DF, Zaritsky A, Bauman LA, Dockery K, James RL, Conrad D, et al.: Instillation of calf lung surfactant extract (calfactant) is beneficial in pediatric acute hypoxemic respiratory failure. Members of the Mid-Atlantic Pediatric Critical Care Network. Crit Care Med 1999, 27:188-195. This study highlights the problem with designing clinical trials using historical control data to estimate power calculations. The mortality in pediatric ARDS is now consistently reported to be <30%.
27. 2 with no improvement in outcome. See accompanying editorial (Bohn D).
28. 28 Michel JR, Barton RG, Saffle JR, et al.: Inhaled nitric oxide versus conventional therapy: effect on oxygenation in ARDS. Am J Respir Crit Care Med 1998, 157:1372-1380.
29. 29 Ream RS, Hauver JF, Lynch RE, Kountzman B, Gale GB, Mink RB: Low-dose inhaled nitric oxide improves the oxygenation and ventilation of infants and children with acute hypoxemic respiratory failure. Crit Care Med 1999, 27:989-996.
30. 30 Shekerdemian L, Bohn D: Cardiovascular effects of mechanical ventilation. Arch Dis Child 1999, 80:475-480. A comprehensive review of the important interactions between the heart and lungs, highlighting important physiological differences in the effect of intrathoracic pressure in right and left heart failure.
31. 31 Shekerdemian LS, Shore DF, Lincoln C, Bush A, Redington AN: Negativepressure ventilation improves cardiac output after right heart surgery. Circulation 1996, 94(suppl 2):49-55.
32. 32 Shekerdemian LS, Bush A, Shore DF, Lincoln C, Redington AN: Cardiopulmonary interactions after Fontan operations: augmentation of cardiac output using negative pressure ventilation. Circulation 1997, 96:3934-3942.
33. 33 Shekerdemian LS, Bush A, Shore DF, Lincoln C, Redington AN: Cardiorespiratory responses to negative pressure ventilation after tetralogy of Fallot repair: a hemodynamic tool for patients with a low-output state. J Am Coll Cardiol 1999, 33(2):549-555. A highly innovative approach to ventilation in children with right heart failure. This study shows that negative pressure ventilation improves cardiac output in children with tetralogy of Fallot.