Others (Sedation, Hemodynamics, Nutrition, Infection)

Children on prolonged mechanical ventilation (PMV) face a different set of complications compared to those on short-term mechanical ventilation (MV). Prolonged hospitalization and exposure to sedatives and analgesics predispose them to higher risk of iatrogenic withdrawal syndrome and intensive care unit (ICU) delirium. Under- and overfeeding are also prevalent in this group of patients due to variability in underlying medical condition, respiratory function, body composition, and physical ability. Children on PMV are also susceptible to hemodynamic changes from cardiopulmonary interaction, infections, and sleep-disordered breathing. Understanding these potential complications helps clinicians formulate individualized management plan that optimizes outcomes for this group of patients. This chapter discusses on important supportive management (i.e., analgesia and sedation, nutrition, hemodynamics, infection control, and sleep-disordered breathing) of children on PMV.