Intraoperative mechanical ventilation for the pediatric patient

Martin C. J. Kneyber*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

13 Citations (Scopus)

Abstract

Invasive mechanical ventilation is required when children undergo general anesthesia for any procedure. It is remarkable that one of the most practiced interventions such as pediatric mechanical ventilation is hardly supported by any scientific evidence but rather based on personal experience and data from adults, especially as ventilation itself is increasingly recognized as a harmful intervention that causes ventilator-induced lung injury. The use of low tidal volume and higher levels of positive end-expiratory pressure became an integral part of lung-protective ventilation following the outcomes of clinical trials in critically ill adults. This approach has been readily adopted in pediatric ventilation. However, a clear association between tidal volume and mortality has not been ascertained in pediatrics. In fact, experimental studies have suggested that young children might be less susceptible to ventilator-induced lung injury. As such, no recommendations on optimal lung-protective ventilation strategy in children with or without lung injury can be made. (C) 2015 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)371-379
Number of pages9
JournalBest practice & research. Clinical anaesthesiology
Volume29
Issue number3
DOIs
Publication statusPublished - Sep-2015

Keywords

  • ventilation
  • children
  • tidal volume
  • ventilator-induced lung injury
  • RESPIRATORY-DISTRESS-SYNDROME
  • ACUTE LUNG INJURY
  • TIDAL-VOLUME VENTILATION
  • END-EXPIRATORY PRESSURE
  • RANDOMIZED CONTROLLED-TRIAL
  • CHEST-WALL COMPLIANCE
  • ABDOMINAL-SURGERY
  • GENERAL-ANESTHESIA
  • PULMONARY-FUNCTION
  • INTENSIVE-CARE

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