Contemporary Ventilatory Strategies For Surgical Patients
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In brief
In brief
This article reviews contemporary mechanical ventilation strategies for critically ill surgical children, emphasizing lung-protective approaches to minimize ventilator-induced injury. It examines alternatives to conventional ventilation including high-frequency modes, neurally adjusted support, and non-invasive techniques tailored to pediatric surgical populations.
Written by the GCMD Library team from the article.
Publication date: Available online 18 January 2019
Source: Seminars in Pediatric Surgery
Author(s): Ana Ruzic
Abstract
Respiratory failure affects a significant percentage of critically ill children, necessitating both invasive and non-invasive respiratory support. As the outcomes of these patients have improved, children with higher acuity and more complex respiratory pathophysiology require mechanical ventilation. Despite growing understanding of lung-protective strategies and ventilation induced lung injury, certain patients still require harmful ventilatory settings with conventional mechanical ventilation (CMV). High frequency ventilation, neurally adjusted ventilatory assist, and airway pressure release ventilation offer feasible alternatives to CMV. In addition to minimizing the risk of ventilatory induced lung injury when used appropriately, they provide a unique environment to facilitate operations on certain neonates and older children. Finally, non-invasive ventilation is now commonly employed in children with surgical conditions.