Prediction of ventilation weaning outcome children are not little adults 英文参考文献.docVIP

Available online /content/9/6/651 Commentary Prediction of ventilation weaning outcome: children are not little adults Margrid B Schindler Consultant in Paediatric Intensive Care, Paediatric Intensive Care Unit, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, United Kingdom Corresponding author: Margrid B Schindler, Margrid.Schindler@ubht.swest.nhs.uk Published online: 25 November 2005 Critical Care 2005, 9:651-652 (DOI 10.1186/cc3950) This article is online at /content/9/6/651 ? 2005 BioMed Central Ltd See related research by Leclerc et al. in this issue [/content/9/6/R798] Abstract appear to apply if performed immediately pre-extubation [4]. Major efforts have been made to identify parameters that can predict extubation failure in children, but a clearly defined set of risk factors has not yet been established. Leclerc et al. [1] also found that the ACCP adult criteria were poor predictors of weaning outcome in children. Prediction of ventilation weaning outcome in children is important, as unsuccessful extubation increases both morbidity and mortality. Adult weaning criteria are poor predictors of weaning outcome in children for several possible reasons: the length of mechanical ventilation is generally much shorter, and the weaning failure rate is lower in children (thus larger patient numbers are required); integrated weaning indices, such as the rapid shallow breathing index, do not account for normal developmental changes in There are several possible reasons for this discrepancy between adult and paediatric studies. In the adult studies, the length of mechanical ventilation and failed weaning rate are higher than in children, thus possibly allowing identification of risk factors using smaller numbers of patients. In the adult studies, the median length of ventilation was 8 to 11 days [3,4], and weaning failure rates were