Operational Definitions Related to Pediatric Ventilator Liberation

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dc.contributor.authorAbu-Sultaneh, Samer
dc.contributor.authorIyer, Narayan Prabhu
dc.contributor.authorFernández, Analía
dc.contributor.authorGaies, Michael
dc.contributor.authorGonzález-Dambrauskas, Sebastián
dc.contributor.authorHotz, Justin Christian
dc.contributor.authorKneyber, Martin C.J.
dc.contributor.authorLópez-Fernández, Yolanda M.
dc.contributor.authorRotta, Alexandre T.
dc.contributor.authorWerho, David K.
dc.contributor.authorBaranwal, Arun Kumar
dc.contributor.authorBlackwood, Bronagh
dc.contributor.authorCraven, Hannah J.
dc.contributor.authorCurley, Martha A.Q.
dc.contributor.authorEssouri, Sandrine
dc.contributor.authorFioretto, Jose Roberto [UNESP]
dc.contributor.authorHartmann, Silvia M.M.
dc.contributor.authorJouvet, Philippe
dc.contributor.authorKorang, Steven Kwasi
dc.contributor.authorRafferty, Gerrard F.
dc.contributor.authorRamnarayan, Padmanabhan
dc.contributor.authorRose, Louise
dc.contributor.authorTume, Lyvonne N.
dc.contributor.authorWhipple, Elizabeth C.
dc.contributor.authorWong, Judith Ju Ming
dc.contributor.authorEmeriaud, Guillaume
dc.contributor.authorMastropietro, Christopher W.
dc.contributor.authorNapolitano, Natalie
dc.contributor.authorNewth, Christopher J.L.
dc.contributor.authorKhemani, Robinder G.
dc.contributor.institutionIndiana University School of Medicine
dc.contributor.institutionUniversity of Southern California
dc.contributor.institutionHospital General de Agudos “C. Durand” Ciudad Autónoma de Buenos Aires
dc.contributor.institutionCincinnati Children's Hospital Medical Center Heart Institute
dc.contributor.institutionUniversidad de la República
dc.contributor.institutionChildren's Hospital Los Angeles
dc.contributor.institutionUniversity of Groningen
dc.contributor.institutionBiocruces-Bizkaia Health Research Institute
dc.contributor.institutionDuke University
dc.contributor.institutionRady Children's Hospital
dc.contributor.institutionPostgraduate Institute of Medical Education and Research
dc.contributor.institutionQueen's University Belfast
dc.contributor.institutionUniversity of Pennsylvania School of Nursing
dc.contributor.institutionChildren's Hospital of Philadelphia
dc.contributor.institutionUniversité de Montréal
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionSeattle Children's Hospital and University of Washington
dc.contributor.institutionCopenhagen University Hospital
dc.contributor.institutionKing's College London
dc.contributor.institutionImperial College London
dc.contributor.institutionEdge Hill University Health Research Institute
dc.contributor.institutionKK Women's and Children's Hospital
dc.contributor.institutionUniversity of Southern California Keck School of Medicine
dc.date.accessioned2023-07-29T13:50:25Z
dc.date.available2023-07-29T13:50:25Z
dc.date.issued2023-05-01
dc.description.abstractBackground: Common, operational definitions are crucial to assess interventions and outcomes related to pediatric mechanical ventilation. These definitions can reduce unnecessary variability among research and quality improvement efforts, to ensure findings are generalizable, and can be pooled to establish best practices. Research Question: Can we establish operational definitions for key elements related to pediatric ventilator liberation using a combination of detailed literature review and consensus-based approaches? Study Design and Methods: A panel of 26 international experts in pediatric ventilator liberation, two methodologists, and two librarians conducted systematic reviews on eight topic areas related to pediatric ventilator liberation. Through a series of virtual meetings, we established draft definitions that were voted upon using an anonymous web-based process. Definitions were revised by incorporating extracted data gathered during the systematic review and discussed in another consensus meeting. A second round of voting was conducted to confirm the final definitions. Results: In eight topic areas identified by the experts, 16 preliminary definitions were established. Based on initial discussion and the first round of voting, modifications were suggested for 11 of the 16 definitions. There was significant variability in how these items were defined in the literature reviewed. The final round of voting achieved ≥ 80% agreement for all 16 definitions in the following areas: what constitutes respiratory support (invasive mechanical ventilation and noninvasive respiratory support), liberation and failed attempts to liberate from invasive mechanical ventilation, liberation from respiratory support, duration of noninvasive respiratory support, total duration of invasive mechanical ventilation, spontaneous breathing trials, extubation readiness testing, 28 ventilator-free days, and planned vs rescue use of post-extubation noninvasive respiratory support. Interpretation: We propose that these consensus-based definitions for elements of pediatric ventilator liberation, informed by evidence, be used for future quality improvement initiatives and research studies to improve generalizability and facilitate comparison.en
dc.description.affiliationDivision of Pediatric Critical Care Department of Pediatrics Riley Hospital for Children at Indiana University Health Indiana University School of Medicine
dc.description.affiliationRuth Lilly Medical Library Indiana University School of Medicine
dc.description.affiliationFetal and Neonatal Institute Division of Neonatology Children's Hospital Los Angeles Department of Pediatrics Keck School of Medicine University of Southern California
dc.description.affiliationPediatric Critical Care Unit Hospital General de Agudos “C. Durand” Ciudad Autónoma de Buenos Aires
dc.description.affiliationDepartment of Pediatrics Division of Pediatric Cardiology University of Cincinnati College of Medicine Cincinnati Children's Hospital Medical Center Heart Institute
dc.description.affiliationRed Colaborativa Pediátrica de Latinoamérica (LARed Network) and Departamento de Pediatría Unidad de Cuidados Intensivos de Niños del Centro Hospitalario Pereira Rossell Facultad de Medicina Universidad de la República
dc.description.affiliationDepartment of Anesthesiology and Critical Care Children's Hospital Los Angeles
dc.description.affiliationDepartment of Paediatrics Division of Paediatric Critical Care Medicine Beatrix Children's Hospital University Medical Center Groningen University of Groningen, The Netherlands
dc.description.affiliationDepartment of Pediatrics Pediatric Critical Care Division Cruces University Hospital Biocruces-Bizkaia Health Research Institute, Bizkaia
dc.description.affiliationDivision of Pediatric Critical Care Medicine Department of Pediatrics Duke University
dc.description.affiliationDivision of Pediatric Cardiology Cardiothoracic Intensive Care UC San Diego Rady Children's Hospital
dc.description.affiliationDepartment of Pediatrics Postgraduate Institute of Medical Education and Research
dc.description.affiliationWellcome-Wolfson Institute for Experimental Medicine Queen's University Belfast, Northern Ireland
dc.description.affiliationFamily and Community Health University of Pennsylvania School of Nursing
dc.description.affiliationResearch Institute Children's Hospital of Philadelphia
dc.description.affiliationDepartment of Pediatrics Sainte-Justine Hospital Université de Montréal
dc.description.affiliationDepartment of Pediatrics Pediatric Critical Care Division Botucatu Medical School-UNESP-São Paulo State University, SP
dc.description.affiliationDivision of Critical Care Medicine Department of Pediatrics Seattle Children's Hospital and University of Washington
dc.description.affiliationCopenhagen Trial Unit Centre for Clinical Intervention Research The Capital Region of Denmark Rigshospitalet Copenhagen University Hospital
dc.description.affiliationCentre for Human and Applied Physiological Sciences Faculty of Life Sciences & Medicine King's College London, England
dc.description.affiliationDepartment of Surgery and Cancer Faculty of Medicine Imperial College London, England
dc.description.affiliationFlorence Nightingale Faculty of Nursing Midwifery and Palliative Care King's College London, England
dc.description.affiliationEdge Hill University Health Research Institute, England
dc.description.affiliationKK Women's and Children's Hospital
dc.description.affiliationRespiratory Therapy Department Children's Hospital of Philadelphia
dc.description.affiliationDepartment of Anesthesiology and Critical Care Children's Hospital Los Angeles University of Southern California Keck School of Medicine
dc.description.affiliationUnespDepartment of Pediatrics Pediatric Critical Care Division Botucatu Medical School-UNESP-São Paulo State University, SP
dc.format.extent1130-1143
dc.identifierhttp://dx.doi.org/10.1016/j.chest.2022.12.010
dc.identifier.citationChest, v. 163, n. 5, p. 1130-1143, 2023.
dc.identifier.doi10.1016/j.chest.2022.12.010
dc.identifier.issn1931-3543
dc.identifier.issn0012-3692
dc.identifier.scopus2-s2.0-85152244985
dc.identifier.urihttp://hdl.handle.net/11449/248671
dc.language.isoeng
dc.relation.ispartofChest
dc.sourceScopus
dc.subjectairway extubation
dc.subjectextubation failure
dc.subjecthigh-flow nasal cannula
dc.subjectmechanical ventilation
dc.subjectnoninvasive ventilation
dc.subjectpediatric ICU
dc.subjectventilator weaning
dc.titleOperational Definitions Related to Pediatric Ventilator Liberationen
dc.typeArtigo
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