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Aim <p>To explore ventilator settings, ventilation variables and parameters in critically ill pediatric patients across European Centers.</p> Methods <p>International, multicenter, prospective observational study, collecting ventilation data for 7&#xa0;days from patients aged ≤ 12&#xa0;years, requiring ventilatory support for ≥ 12&#xa0;h. Primary endpoint was a set of key ventilator settings, including tidal volume (V<sub>T</sub>), respiratory rate (RR), peak and mean airway pressure (Ppeak and Pmean), positive end–expiratory pressure (PEEP), and the fraction of inspired oxygen (FiO<sub>2</sub>). Ventilator settings were compared across neonates (aged &lt; 1&#xa0;month), infants (1 to 12&#xa0;months), toddlers (1 to 3&#xa0;years) and children (4 to 12&#xa0;years), and between patients with and without pediatric acute respiratory distress syndrome (PARDS).</p> Results <p>Patients enrolment occurred in 43 centers in 11 countries, with a total of 166 patients—mostly infants—included in this analysis. The majority began with invasive ventilation, while one–third started with noninvasive ventilation (NIV) or high–flow nasal oxygen (HFNO). Patients on invasive ventilation, NIV and HFNO were weaned within a median of 3 [2–6], 3 [2–4] and 3 [2–4] days, respectively. In 22% of patients, NIV or HFNO was used following invasive ventilation. V<sub>T</sub>, RR and FiO<sub>2</sub> varied across age groups, and airway pressures were higher in PARDS patients.</p> Conclusions <p>In this cohort, ventilator settings, and ventilation variables and parameters, varied between individual patients and across patient groups. Larger studies are needed to confirm this variability, explore associations between ventilation practices and clinical outcomes, and assess temporal and geo–economic differences.</p>

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Ventilator Settings in Critically Ill Pediatric Patients (VESPer)—insights from a European Registry

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月7日

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  • Relin van Vliet,
  • David M. P. van Meenen,
  • Robert G. T. Blokpoel,
  • G. Justin M. Woerlee,
  • Frederique Paulus,
  • Marcus J. Schultz,
  • Martin C. J. Kneyber,
  • Clara Abadesso,
  • Elena Álvarez-Rojas,
  • David Arjona Villanueva,
  • María José Arroyo-Marín,
  • Yasemin Ataman,
  • Ebru Atike Ongun,
  • Claire-Marie Barbier,
  • Alicja Bartkowska-Sniatkowska,
  • Florent Baudin,
  • Ayse Berna Anil,
  • Bronagh Blackwood,
  • Cristina Calvo,
  • Cristina Camilo,
  • Fabrizio Chiusolo,
  • Joana Correia,
  • Anna Deho,
  • Sandra Dijkstra,
  • Alexandra Dinis,
  • Jozef de Dooy,
  • Anita Duyndam,
  • Lee P. Ferguson,
  • Mireia Garcia Cusco,
  • Matthieu Genuini,
  • Birthe J. Gesink-van der Veer,
  • Carlos Gil Escobar,
  • Teresa Gili Bigatá,
  • Julia Harris,
  • Merja Kallio,
  • Oliver Karam,
  • Corinna Karsten-Waagmeester,
  • Cecilia Korb,
  • Nurettin Onur Kutlu,
  • Angela Lawton-Woodhall,
  • Pierre-Louis Leger,
  • Joris Lemson,
  • Jean-Michel Liet,
  • Ana M. Llorente de la Fuente,
  • Jorge López,
  • Yolanda M. López-Fernández,
  • Jesús López-Herce,
  • Daniele M. de Luca,
  • Duncan Macrae,
  • Paula Madurga Revilla,
  • Matthieu Maria,
  • Alberto Medina Villaneuva,
  • Reinout Mildner,
  • Vicent Modesto i Alapont,
  • Çağlar Ödek,
  • Eider Oñate Vergara,
  • Outi Peltoniemi,
  • Antonio Pérez-Ferrer,
  • Agnieszka Pietrzak,
  • Javier Pilar-Orive,
  • Julio Parrilla,
  • Sonia Pelluau,
  • Carla R. Pinto,
  • Marti Pons Odena,
  • Paula M. Rocha,
  • Peter P. Roeleveld,
  • Nicolas Roullet-Renolleau,
  • Sylvain Renolleau,
  • Louise Rose,
  • Marcel H. B. Tinnevelt,
  • Elaine Scott,
  • Lyvonne Tume,
  • Pablo del Villar Guerra,
  • Paul Wellman,
  • Marloes IJland

摘要

Aim

To explore ventilator settings, ventilation variables and parameters in critically ill pediatric patients across European Centers.

Methods

International, multicenter, prospective observational study, collecting ventilation data for 7 days from patients aged ≤ 12 years, requiring ventilatory support for ≥ 12 h. Primary endpoint was a set of key ventilator settings, including tidal volume (VT), respiratory rate (RR), peak and mean airway pressure (Ppeak and Pmean), positive end–expiratory pressure (PEEP), and the fraction of inspired oxygen (FiO2). Ventilator settings were compared across neonates (aged < 1 month), infants (1 to 12 months), toddlers (1 to 3 years) and children (4 to 12 years), and between patients with and without pediatric acute respiratory distress syndrome (PARDS).

Results

Patients enrolment occurred in 43 centers in 11 countries, with a total of 166 patients—mostly infants—included in this analysis. The majority began with invasive ventilation, while one–third started with noninvasive ventilation (NIV) or high–flow nasal oxygen (HFNO). Patients on invasive ventilation, NIV and HFNO were weaned within a median of 3 [2–6], 3 [2–4] and 3 [2–4] days, respectively. In 22% of patients, NIV or HFNO was used following invasive ventilation. VT, RR and FiO2 varied across age groups, and airway pressures were higher in PARDS patients.

Conclusions

In this cohort, ventilator settings, and ventilation variables and parameters, varied between individual patients and across patient groups. Larger studies are needed to confirm this variability, explore associations between ventilation practices and clinical outcomes, and assess temporal and geo–economic differences.