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Prolonged Mechanical Ventilation in Children: Review of the Definition

José Colleti1,2, Rafael Teixeira Azevedo3, Felipe Rezende de Oliveira Caino2

  • 1Department of Pediatrics, Hospital Assunção Rede D'Or São Luiz, S.B. do Campo, São Paulo, Brazil.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|May 24, 2021
PubMed

Insights

Defining prolonged mechanical ventilation in children is challenging due to varied definitions, ranging from 48 hours to 6 months. A consensus definition for pediatric prolonged mechanical ventilation is needed.

Area of Science:

  • Pediatric critical care medicine
  • Respiratory physiology
  • Medical informatics

Background:

  • Prolonged mechanical ventilation (PMV) is a critical intervention for pediatric patients with respiratory failure.
  • Existing literature lacks a standardized definition for PMV in children, leading to inconsistencies in research and clinical practice.

Purpose of the Study:

  • To systematically review and analyze the diverse definitions of prolonged mechanical ventilation currently used in pediatric literature.
  • To identify the most common definitions and highlight the need for a unified consensus definition.

Main Methods:

  • A comprehensive literature search was conducted across PubMed, Embase, and Cochrane Library databases.
  • Original research articles on pediatric PMV were identified and analyzed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
  • Extracted data included patient characteristics, ventilation duration, outcomes, and complications.

Main Results:

  • Thirty articles were included in the qualitative analysis, revealing a wide spectrum of PMV definitions, from 48 hours to 6 months.
  • The most frequently cited durations for PMV were greater than 7 days, greater than 14 days, and greater than 21 days.
  • No high-quality evidence supported a specific definition for PMV in the pediatric population.

Conclusions:

  • The current evidence base is insufficient to establish a definitive definition for pediatric prolonged mechanical ventilation.
  • The significant variability in definitions underscores an urgent need for a consensus definition to standardize research and clinical management.
  • Developing a consensus definition will improve comparability of studies and guide best practices in pediatric respiratory care.
Abstract

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