Research
Tracheostomy and mechanical ventilation weaning in children affected by respiratory virus according to a weaning protocol in a pediatric intensive care unit in Argentina: an observational restrospective trial
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* Corresponding author: Gustavo Caprotta gcapro@gmail.com
- † Equal contributors
1 MD, Pediatric Critical Care physician, Head of Pediatric Intensive Care Unit of "Hospital de Trauma y Emergencia Dr. Federico Abete", Malvinas Argentinas Buenos aires, Argentina
2 MD, Pediatric Critical Care physician. Staff and Emergency doctor at "Hospital de Trauma y Emergencia Dr. Federico Abete de Malvinas Argentinas", Buenos Aires, Argentina
3 Bachellor in Respiratory Therapy in intensive care. Coordinator of Respiratory Therapy in the Pediatric Intensive Care Unit at "Hospital de Trauma y Emergencia Dr. Federico Abete de Malvinas Argentinas", Buenos Aires, Argentina
Italian Journal of Pediatrics 2011, 37:5 doi:10.1186/1824-7288-37-5
Published: 19 January 2011Abstract
We describe difficult weaning after prolonged mechanical ventilation in three tracheostomized children affected by respiratory virus infection. Although the spontaneous breathing trials were successful, the patients failed all extubations. Therefore a tracheostomy was performed and the weaning plan was begun. The strategy for weaning was the decrease of ventilation support combining pressure control ventilation (PCV) with increasing periods of continuous positive airway pressure + pressure support ventilation (CPAP + PSV) and then CPAP + PSV with increasing intervals of T-piece. They presented acute respiratory distress syndrome on admission with high requirements of mechanical ventilation (MV).
Intervening factors in the capabilities and loads of the respiratory system were considered and optimized. The average MV time was 69 days and weaning time 31 days.
We report satisfactory results within the context of a directed weaning protocol.