Tags

Type your tag names separated by a space and hit enter

Mechanical ventilation and arterial blood gas measurements 24 hours postextracorporeal life support for survivors of pediatric respiratory failure.
Crit Care Med. 1996 Apr; 24(4):679-82.CC

Abstract

OBJECTIVE

To summarize our institutional experience concerning mechanical ventilation support and blood gas measurements in the 24-hr period following extracorporeal life support (ECLS) for pediatric acute respiratory failure.

DESIGN

Descriptive study.

SETTING

A tertiary pediatric referral center.

PATIENTS

Children aged 1 month to 18 yrs treated with ECLS for acute respiratory failure at University of Michigan Hospitals from November 1982 to June 1993. All patients aged 1 month to 18 yrs who received ECLS for acute respiratory failure were included. Patients who received ECLS primarily for cardiac support or who had a diagnosis of congenital gastrointestinal malformation (i.e. congenital diaphragmatic hernia) were excluded.

INTERVENTIONS

ECLS for severe pediatric respiratory failure.

MEASUREMENTS AND MAIN RESULTS

Forty-nine children were treated at our center with ECLS for acute respiratory failure 36 (73%) survived. Ventilator settings immediately after decannulation from ECLS for survivors were as follows: FIO2 0.53 +/- 0.18 (SD); intermittent mandatory ventilation (IMV) 29.6 +/- 1.18 breaths/min, positive end-expiratory pressure 5.3 +/- 1.6 cm H2O, mean airway pressure 12.6 +/- 2.9 cm H2O, and peak inspiratory pressure 31.7 +/- 5.5 cm H2O. Arterial blood gas measurements at decannulation were PaO2 89.4 +/- 30.9 torr (11.9 +/- 4.1 kPa), PaCO2 43.7 +/- 9.7 torr (5.8 +/- 1.3 kPa), and pH 7.39 +/- 0.07. Twenty-four hours after decannulation, ventilator settings and arterial blood gas measurements were as follows: FIO2 0.42 +/- 0.14, IMV 27.4 +/- 13.5 breaths/min, positive end-expiratory pressure 5.2 +/- 1.6 cm H2O, mean airway pressure 12.0 +/- 3.4 cm H2O, peak inspiratory pressure 31.1 +/- 6.5 cm H2O, PaO2 77.0 +/- 16.9 torr (10.3 +/- 2.3 kPa), PaCO2 44.9 +/- 8.4 torr (6.0 +/- 1.1 kPa), and pH 7.40 +/- 0.07. Variables associated with oxygenation status (P[A-a]O2) and mean airway pressure (oxygenation index) improved during the immediate 24-hr period postbypass (p < .05).

CONCLUSIONS

Successful decannulation from ECLS for > 24 hrs resulted in long-term survival in 97% (36/37) of children. Ventilator parameters and arterial blood gas measurements during the 24-hr period following bypass have been described for this population. Such conventional support may indicate safe levels of oxygen and mechanical ventilation pressures for the postbypass recovering lung.

Authors+Show Affiliations

Moler FW
Section of Critical Care Medicine, University of Michigan Hospitals, Ann Arbor 48109-0243, USA.
Palmisano JM
No affiliation info available
Custer JR
No affiliation info available
Bartlett RH
No affiliation info available

MeSH

Acute DiseaseAdolescentCarbon DioxideChildChild, PreschoolFemaleHumansInfantLife Support CareMaleOxygenRespiration, ArtificialRespiratory InsufficiencySurvivorsTime FactorsVentilator Weaning

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

8612422

Citation

Moler, F W., et al. "Mechanical Ventilation and Arterial Blood Gas Measurements 24 Hours Postextracorporeal Life Support for Survivors of Pediatric Respiratory Failure." Critical Care Medicine, vol. 24, no. 4, 1996, pp. 679-82.
Moler FW, Palmisano JM, Custer JR, et al. Mechanical ventilation and arterial blood gas measurements 24 hours postextracorporeal life support for survivors of pediatric respiratory failure. Crit Care Med. 1996;24(4):679-82.
Moler, F. W., Palmisano, J. M., Custer, J. R., & Bartlett, R. H. (1996). Mechanical ventilation and arterial blood gas measurements 24 hours postextracorporeal life support for survivors of pediatric respiratory failure. Critical Care Medicine, 24(4), 679-82.
Moler FW, et al. Mechanical Ventilation and Arterial Blood Gas Measurements 24 Hours Postextracorporeal Life Support for Survivors of Pediatric Respiratory Failure. Crit Care Med. 1996;24(4):679-82. PubMed PMID: 8612422.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mechanical ventilation and arterial blood gas measurements 24 hours postextracorporeal life support for survivors of pediatric respiratory failure. AU - Moler,F W, AU - Palmisano,J M, AU - Custer,J R, AU - Bartlett,R H, PY - 1996/4/1/pubmed PY - 1996/4/1/medline PY - 1996/4/1/entrez SP - 679 EP - 82 JF - Critical care medicine JO - Crit Care Med VL - 24 IS - 4 N2 - OBJECTIVE: To summarize our institutional experience concerning mechanical ventilation support and blood gas measurements in the 24-hr period following extracorporeal life support (ECLS) for pediatric acute respiratory failure. DESIGN: Descriptive study. SETTING: A tertiary pediatric referral center. PATIENTS: Children aged 1 month to 18 yrs treated with ECLS for acute respiratory failure at University of Michigan Hospitals from November 1982 to June 1993. All patients aged 1 month to 18 yrs who received ECLS for acute respiratory failure were included. Patients who received ECLS primarily for cardiac support or who had a diagnosis of congenital gastrointestinal malformation (i.e. congenital diaphragmatic hernia) were excluded. INTERVENTIONS: ECLS for severe pediatric respiratory failure. MEASUREMENTS AND MAIN RESULTS: Forty-nine children were treated at our center with ECLS for acute respiratory failure 36 (73%) survived. Ventilator settings immediately after decannulation from ECLS for survivors were as follows: FIO2 0.53 +/- 0.18 (SD); intermittent mandatory ventilation (IMV) 29.6 +/- 1.18 breaths/min, positive end-expiratory pressure 5.3 +/- 1.6 cm H2O, mean airway pressure 12.6 +/- 2.9 cm H2O, and peak inspiratory pressure 31.7 +/- 5.5 cm H2O. Arterial blood gas measurements at decannulation were PaO2 89.4 +/- 30.9 torr (11.9 +/- 4.1 kPa), PaCO2 43.7 +/- 9.7 torr (5.8 +/- 1.3 kPa), and pH 7.39 +/- 0.07. Twenty-four hours after decannulation, ventilator settings and arterial blood gas measurements were as follows: FIO2 0.42 +/- 0.14, IMV 27.4 +/- 13.5 breaths/min, positive end-expiratory pressure 5.2 +/- 1.6 cm H2O, mean airway pressure 12.0 +/- 3.4 cm H2O, peak inspiratory pressure 31.1 +/- 6.5 cm H2O, PaO2 77.0 +/- 16.9 torr (10.3 +/- 2.3 kPa), PaCO2 44.9 +/- 8.4 torr (6.0 +/- 1.1 kPa), and pH 7.40 +/- 0.07. Variables associated with oxygenation status (P[A-a]O2) and mean airway pressure (oxygenation index) improved during the immediate 24-hr period postbypass (p < .05). CONCLUSIONS: Successful decannulation from ECLS for > 24 hrs resulted in long-term survival in 97% (36/37) of children. Ventilator parameters and arterial blood gas measurements during the 24-hr period following bypass have been described for this population. Such conventional support may indicate safe levels of oxygen and mechanical ventilation pressures for the postbypass recovering lung. SN - 0090-3493 UR - https://www.unboundmedicine.com/medline/citation/8612422/Mechanical_ventilation_and_arterial_blood_gas_measurements_24_hours_postextracorporeal_life_support_for_survivors_of_pediatric_respiratory_failure_ DB - PRIME DP - Unbound Medicine ER -