Related Experiment Video
Updated: Apr 17, 2026
Combining Volumetric Capnography And Barometric Plethysmography To Measure The Lung Structure-function Relationship
Published on: January 8, 2019
Variation of ventilation practices with center volume after pediatric heart surgery
Punkaj Gupta1, Xinyu Tang, Jeffrey M Gossett
1Division of Pediatric Critical Care, Department of Pediatrics, University of Arkansas Medical Center, Little Rock, Arkansas; Division of Pediatric Cardiology, Department of Pediatrics, University of Arkansas Medical Center, Little Rock, Arkansas.
Background:
This study was designed to evaluate the odds of mechanical ventilation and duration of mechanical ventilation after pediatric cardiac surgery across centers of varying center volume using the Virtual PICU Systems database.
Hypothesis:
Children receiving cardiac surgery at high-volume centers will be associated with lower odds of mechanical ventilation and shorter duration of mechanical ventilation, compared with low-volume centers.
Methods:
Patients age <18 years undergoing operations (with or without cardiopulmonary bypass) for congenital heart disease at one of the participating intensive care units in the Virtual PICU Systems database were included (2009-2013). Logistic regression models and Cox proportional hazards models were fitted for the probability of conventional mechanical ventilation and duration of mechanical ventilation, respectively, to investigate the difference in the outcomes between different center volume groups with/without adjustment for other risk factors.
Results:
A total of 10 378 patients from 43 centers qualified for inclusion. Of these, 7648 (74%) patients received conventional mechanical ventilation after cardiac surgery. Higher center volume was significantly associated with lower odds of mechanical ventilation after cardiac surgery (odds ratio: 2.68, 95% confidence interval: 2.15-3.35). However, patients receiving mechanical ventilation in these centers were associated with longer duration of mechanical ventilation, compared with lower-volume centers (hazard ratio: 1.26, 95% confidence interval: 1.16-1.37). This association was most prominent in the lower surgical-risk categories.
Conclusions:
Large clinical practice variations were demonstrated for mechanical ventilation following pediatric cardiac surgery among intensive care units of varied center volumes.
Related Concept Videos
01:14Ventilatory Modes
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
01:23Mechanical Ventilation II: Invasive Ventilation
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
01:29Mechanical Ventilation I: Indication and Settings
01:23Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...
01:19Factors Affecting Pulmonary Ventilation
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
01:29Assessment of Ventilation II: Respiratory Depth and Rhythm
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement: