Santschi Miriam, Gauvin France, Hatzakis Georges, Lacroix Jacques, Jouvet Philippe
Pediatric Intensive Care Unit, Hôpital Sainte-Justine, Université de Montréal, 3175 chemin Côte Sainte Catherine, Montréal, Quebec, H3T 1C5, Canada.
Intensive Care Med. 2007 Feb;33(2):319-25. doi: 10.1007/s00134-006-0414-0. Epub 2006 Oct 25.
The aim of this survey was to characterize the physiological limits considered appropriate during weaning from mechanical ventilation in children.
Two hundred twenty-two (222) intensivists from 63 pediatric intensive care units (PICUs) were asked to provide the limits they considered acceptable for respiratory rate (RR), tidal volume (V(T)) and end-tidal CO(2) (PetCO(2)) during weaning from mechanical ventilation of a 3-month-old, a 2-year-old and a 10-year-old patient.
Pediatric intensivists working in Canada, France, Switzerland and Belgium.
None.
None.
Ninety-seven intensivists (43%) from 49 PICUs responded to the survey. The median minimal RR (25th;75th percentile) was: 20 breaths per minute (bpm) (15;25) for the 3-month-old, 15 bpm (10;15) for the 2-year-old and 10 bpm (10;15) for the 10-year-old patient. The median maximal RR was 50 bpm (40;60) for the 3-month-old, 40 bpm (30;40) for the 2-year-old and 30 bpm (30;40) for the 10-year-old child. The median minimal V(T) was 5 ml/kg (4;6) for the 3-month-old and 2-year-old patients and 5 ml/kg (5;6) for the 10-year-old. The median maximal PetCO(2) was 55 mmHg (50;60) for the 3-month-old, 50 mmHg (45;50) for the 2-year-old and 50 mmHg (50;55) for the 10-year-old.
This survey indicated that acceptable weaning limits are broad, as stated by the responders. We need to organize and consolidate our thinking on weaning children from mechanical ventilation before guidelines can be established.
本次调查旨在明确儿童机械通气撤机过程中被认为合适的生理限度。
来自63个儿科重症监护病房（PICU）的222名重症监护医生被要求提供他们认为3个月大、2岁和10岁患者机械通气撤机过程中呼吸频率（RR）、潮气量（V(T)）和呼气末二氧化碳（PetCO(2)）可接受的限度。
在加拿大、法国、瑞士和比利时工作的儿科重症监护医生。
无。
无。
来自49个PICU的97名重症监护医生（43%）回复了调查。3个月大患者的RR中位数（第25百分位数；第75百分位数）为每分钟20次呼吸（bpm）（15；25），2岁患者为15 bpm（10；15），10岁患者为10 bpm（10；15）。3个月大患者的RR最大值中位数为50 bpm（40；60），2岁患者为40 bpm（30；40），10岁儿童为30 bpm（30；40）。3个月大及2岁患者的V(T)最小值中位数为5 ml/kg（4；6），10岁患者为5 ml/kg（5；6）。3个月大患者的PetCO(2)最大值中位数为55 mmHg（50；60），2岁患者为50 mmHg（45；50），10岁患者为50 mmHg（50；55）。
本次调查表明，如回复者所述，可接受的撤机限度范围较宽。在制定指南之前，我们需要整理并巩固关于儿童机械通气撤机的思路。
