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Complications during mechanical ventilation-A pediatric intensive care perspective

Shawn Sood1, Hammad A Ganatra1, Francesca Perez Marques1

  • 1Division of Pediatric Critical Care, Kansas University Medical Center, Kansas City, KS, United States.

Frontiers in Medicine
|February 23, 2023
PubMed

Insights

Mechanical ventilation is common in pediatric intensive care units. This review details frequent complications, their risk factors, and management strategies for pediatric patients on mechanical ventilators.

Area of Science:

  • Pediatric critical care medicine
  • Respiratory therapy
  • Intensive care unit (ICU) management

Background:

  • Mechanical ventilation is a frequent intervention in pediatric intensive care units (PICUs), with over 20% of patients needing invasive support.
  • Respiratory failure, stemming from respiratory compromise or neurological conditions, is the primary reason for endotracheal intubation and ventilation in children.
  • Despite employing lung-protective ventilation strategies, pediatric patients frequently experience complications.

Purpose of the Study:

  • This review aims to comprehensively discuss the complications associated with mechanical ventilation in the pediatric population.
  • It will cover the identification of risk factors, clinical presentation, and effective management approaches for these complications.
  • The focus is on improving outcomes for critically ill children requiring ventilatory support.

Main Methods:

  • This is a review article, synthesizing existing literature on mechanical ventilation complications in pediatrics.
  • Information was gathered from relevant studies and clinical guidelines.
  • The review focuses on risk factors, clinical presentation, and management strategies.

Main Results:

  • Common complications include atelectasis, post-extubation stridor, perioral tissue damage, ventilator-associated pneumonia, mucus plugging, pneumothorax, pneumomediastinum, and ICU neuromyopathy.
  • Risk factors vary depending on the specific complication and patient condition.
  • Management strategies are tailored to the individual complication and patient's clinical status.

Conclusions:

  • Mechanical ventilation, while essential, carries significant risks for pediatric patients.
  • Early recognition of risk factors and prompt, appropriate management are crucial for mitigating complications.
  • Further research into optimizing ventilation strategies and reducing adverse events in pediatric populations is warranted.

Keywords:
atelectasiscomplicationsdeliriummechanical ventilationmyopathypediatricpediatric intensive caresubglottic stenosis

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