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Invasive ventilation modes in children: a systematic review and meta-analysis

Anita Duyndam1, Erwin Ista, Robert Jan Houmes

  • 1Intensive Care Unit, Erasmus MC - Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, The Netherlands.

Critical Care (London, England)
|January 19, 2011
PubMed

Insights

This review found no significant differences in mortality or ventilation duration across various artificial respiration modes in children. High-frequency ventilation showed improved oxygenation but not reduced mortality.

Area of Science:

  • Pediatric critical care medicine
  • Respiratory physiology
  • Evidence-based medicine

Background:

  • Mechanical ventilation is crucial for critically ill children.
  • Optimal ventilation mode selection remains a challenge, especially beyond the neonatal period.
  • Limited comparative data exists for pediatric ventilation strategies.

Purpose of the Study:

  • To critically review evidence on artificial respiration modes for children up to 18 years.
  • To compare the efficacy of different ventilation modes based on key clinical outcomes.

Main Methods:

  • Systematic literature search of PubMed and EMBASE databases.
  • Inclusion of randomized controlled trials comparing two ventilation modes.
  • Analysis of outcomes including length of ventilation, oxygenation, mortality, and weaning.

Main Results:

  • Five trials involving 421 children compared six ventilation modes (HFO, PC, PS, VS, VDR, biphasic positive airway pressure).
  • No significant differences were found in length of ventilation or mortality.
  • High-frequency ventilation (HFO, VDR) demonstrated improved oxygenation compared to conventional methods.

Conclusions:

  • Scarce data exists for optimal ventilation modes in critically ill children post-newborn period.
  • Current evidence does not support high-frequency ventilation for reduced mortality or ventilation duration.
  • Future research should focus on long-term outcomes like pulmonary function and neurocognitive development.
Abstract

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