Burhan Nalbantoglu Hastanesi, Lefkosa, KKTC, Mersin, Turkey.
Tepecik Hospital, Pediatric ICU, Pediatrics, Izmir, Turkey.
Pediatr Crit Care Med. 2020 May;21(5):e253-e258. doi: 10.1097/PCC.0000000000002272.
To investigate conventional mechanical ventilation weaning characteristics of patients requiring conventional mechanical ventilation support for greater than 48 hours within the PICU.
The prospective observational multicenter cohort study was conducted at 15 hospitals. Data were being collected from November 2013 to June 2014, with two designated researchers from each center responsible for follow-up and data entry.
Fifteen tertiary PICUs in Turkey.
Patients between 1 month and 18 years old requiring conventional mechanical ventilation for greater than 48 hours were included. A single-center was not permitted to surpass 20% of the total sample size. Patients with no plans for conventional mechanical ventilation weaning were excluded.
Conventional mechanical ventilation MEASUREMENTS AND MAIN RESULTS:: Pertinent variables included PICU and patient demographics, including clinical data, chronic diseases, comorbid conditions, and reasons for intubation. Conventional mechanical ventilation mode and weaning data were characterized by daily ventilator parameters and blood gases. Patients were monitored until hospital discharge. Of the 410 recruited patients, 320 were included for analyses. A diagnosis of sepsis requiring intubation and high initial peak inspiratory pressures correlated with a longer weaning period (mean, 3.65 vs 1.05-2.17 d; p < 0.001). Conversely, age, admission Pediatric Risk of Mortality III scores, days of conventional mechanical ventilation before weaning, ventilator mode, and chronic disease were not related to weaning duration.
Pediatric patients requiring conventional mechanical ventilation with a diagnosis of sepsis and high initial peak inspiratory pressures may require longer conventional mechanical ventilation weaning prior to extubation. Causative factors and optimal weaning for this cohort needs further consideration.
调查小儿重症监护病房（PICU）内需要常规机械通气支持超过 48 小时的患者的常规机械通气撤机特征。
这是一项前瞻性观察性多中心队列研究，在 15 家医院进行。数据收集于 2013 年 11 月至 2014 年 6 月，每个中心的两名指定研究人员负责随访和数据录入。
土耳其的 15 个三级 PICU。
纳入年龄在 1 个月至 18 岁之间、需要常规机械通气超过 48 小时的患者。不允许单个中心超过总样本量的 20%。排除无常规机械通气撤机计划的患者。
常规机械通气
相关变量包括 PICU 和患者人口统计学资料，包括临床数据、慢性疾病、合并症和插管原因。常规机械通气模式和撤机数据的特点是每日呼吸机参数和血气。患者被监测至出院。在招募的 410 名患者中，有 320 名被纳入分析。需要插管的败血症诊断和初始高峰吸气压力高与较长的撤机时间相关（平均分别为 3.65 天和 1.05-2.17 天；p < 0.001）。相反，年龄、入院小儿死亡风险评分 III、撤机前常规机械通气天数、呼吸机模式和慢性疾病与撤机时间无关。
需要常规机械通气的小儿败血症和初始高峰吸气压力高的患者在拔管前可能需要更长时间的常规机械通气撤机。这一人群的病因和最佳撤机策略需要进一步考虑。
