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Article Dans Une Revue Intensive Care Medicine Année : 2017

Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC)

1 University of Groningen [Groningen]
2 Division of Pediatrics and Neonatal Critical Care, 'A.Beclere' Medical Center, South Paris University Hospitals, APHP and South Paris-Saclay University
3 Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico
4 Maternité Port-Royal [CHU Cochin]
5 UMRESTTE UMR T9405 - Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement
6 Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, School of Medicine
7 Division of Respiratory and Critical Care Medicine, University Children's Hospital Basel, University of Basel
8 Royal Brompton and Harefield NHS Trust
9 Department of Paediatrics, Division of Paediatric Critical Care Medicine, VU University Medical Center
10 Paediatric Intensive Care Unit, Hospital Universitario Central de Asturias
11 Paediatric Intensive Care and Intermediate Care Department, Sant Joan de Déu Uni-versity Hospital, Universitat de Barcelona
12 Department of Anaesthesia and Intensive Care, Division of Paediatric Intensive Care Unit, Alessandria General Hospital
13 Department of Pediatrics,Children's Hospital Traunstein, Ludwig Maximilians University Munich
14 Department of Paediatrics, Division of Paediatric Emergency and Critical Care, Verona University Hospital
15 Departments of Critical Care and Paediatric Bioethics, Great Ormond St Hospital for Children NHS Trust
16 Service of Neonatology and Pediatric Intensive Care, Department of Paediatrics, University Hospital of Geneva

Résumé

Much of the common practice in paediatric mechanical ventilation is based on personal experiences and what paediatric critical care practitioners have adopted from adult and neonatal experience. This presents a barrier to planning and interpretation of clinical trials on the use of specific and targeted interventions. We aim to establish a European consensus guideline on mechanical ventilation of critically children.MethodsThe European Society for Paediatric and Neonatal Intensive Care initiated a consensus conference of international European experts in paediatric mechanical ventilation to provide recommendations using the Research and Development/University of California, Los Angeles, appropriateness method. An electronic literature search in PubMed and EMBASE was performed using a combination of medical subject heading terms and text words related to mechanical ventilation and disease-specific terms.ResultsThe Paediatric Mechanical Ventilation Consensus Conference (PEMVECC) consisted of a panel of 15 experts who developed and voted on 152 recommendations related to the following topics: (1) general recommendations, (2) monitoring, (3) targets of oxygenation and ventilation, (4) supportive measures, (5) weaning and extubation readiness, (6) normal lungs, (7) obstructive diseases, (8) restrictive diseases, (9) mixed diseases, (10) chronically ventilated patients, (11) cardiac patients and (12) lung hypoplasia syndromes. There were 142 (93.4%) recommendations with ?strong agreement?. The final iteration of the recommendations had none with equipoise or disagreement.ConclusionsThese recommendations should help to harmonise the approach to paediatric mechanical ventilation and can be proposed as a standard-of-care applicable in daily clinical practice and clinical research.
Une grande partie de la pratique courante en ventilation mécanique pédiatrique est basée sur des expériences personnelles et ce que les praticiens en soins intensifs pédiatriques ont adopté à partir de l'expérience adulte et néonatale.

Dates et versions

hal-01777725 , version 1 (27-04-2018)

Identifiants

Citer

Martin C. J. Kneyber, Daniele De Luca, Edoardo Calderini, Pierre-Henri Jarreau, Etienne Javouhey, et al.. Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC). Intensive Care Medicine, 2017, 43 (12), pp. 1764-1780. ⟨10.1007/s00134-017-4920-z⟩. ⟨hal-01777725⟩
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