Mechanical ventilation for children
Conditions
Interventions
Test group:Perform closed suctioning while maintaining continuous ventilation on the ventilator, enter the washout period, and disconnect the ventilator after the washout period is over before open su
Sponsors
Shengjing Hospital of China Medical University
Eligibility
Sex/Gender
All
Age
0.1 Years to 14 Years
Inclusion criteria
Inclusion criteria: (1)Age: Between 28 days and 14 years. (2)Mechanical ventilation: Meets standard criteria for invasive mechanical ventilation and exhibits spontaneous breathing. (3)Hemodynamic and respiratory stability Heart rate within the 10th–90th percentile for age. Mean arterial pressure (MAP) 60–110 mmHg. Peripheral oxygen saturation (SpO2) **> 90%?**. Positive end-expiratory pressure (PEEP) ?<= 10 cmH2O. Respiratory rate ?<= 10th–90th percentile? for age. Vasoactive drug doses:Dopamine < 10 µg·kg?¹·min?¹.(Nor)epinephrine < 0.1 µg·kg?¹·min?¹. (4)No contraindications for chest physiotherapy or suctioning: Severe arrhythmias. Uncontrolled intracranial hypertension. Untreated pneumothorax. Severe coagulopathy. Severe bronchospasm. Unstable fractures. (5)No contraindications for EIT (Electrical Impedance Tomography): Patients with implanted pacemakers or defibrillators. Skin infections or open wounds in the electrode belt contact area? on the thorax. Neuromuscular disorders (e.g., myasthenia gravis) where the electrode belt may restrict breathing. (6)No contraindications for early mobilization: Unstable fractures. Active bleeding. Joint dislocation/subluxation. Extreme respiratory/circulatory instability. (7)Informed consent obtained from the patient’s legal guardian.
Exclusion criteria
Exclusion criteria: (1) Patients who received mechanical ventilation before entering the ICU; (2) Children who had no spontaneous breathing or were administered muscle relaxants during mechanical ventilation; (3) Patients after cardiopulmonary resuscitation; (4) Patients requiring extracorporeal life support; (5) Children with severe acute respiratory distress syndrome; (6) Patients with life-threatening organ failure such as liver or kidney failure requiring extracorporeal circulation treatment.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Recovery time of lung volume loss;Distribution parameters of local lung ventilation (ROI%, COV, RVD%);GI ,t of pixel and Pendelluft;Paw-exp,Cydn,PEEPtot,Ppeak,Pplat,Pmean,Pdriv; | — |
Secondary
| Measure | Time frame |
|---|---|
| Blood pressure (BP), Fraction of inspiration O2 (FiO2), respiratory rate (RR), and heart rate (HR); | — |
Countries
China
Contacts
Public ContactWei Xu
Department of Pediatrics, Shengjing Hospital of China Medical University
Outcome results
None listed