Abstract
Prediction of ventilation weaning outcome in children is important, as unsuccessful extubation increases both morbidity and mortality. Adult weaning criteria are poor predictors of weaning outcome in children for several possible reasons: the length of mechanical ventilation is generally much shorter, and the weaning failure rate is lower in children (thus larger patient numbers are required); integrated weaning indices, such as the rapid shallow breathing index, do not account for normal developmental changes in respiratory function; and the heterogeneity of mechanically ventilated children is greater than in adults. The challenge remains to find universal weaning outcome predictors in children.
Highlights
There are established indices predicting the outcome of trials of weaning from mechanical ventilation, such as the rapid shallow breathing index [3]
Leclerc et al [1] found that the American College of Chest Physicians (ACCP) adult criteria were poor predictors of weaning outcome in children
Adult weaning indices are designed to quantify the extent of rapid shallow breathing (rapid spontaneous respiratory rate (f), low spontaneous tidal volume (Vt) and poor inspiratory effort) as this is a common finding in adult patients who fail weaning [3]
Summary
There are established indices predicting the outcome of trials of weaning from mechanical ventilation, such as the rapid shallow breathing index [3]. The length of mechanical ventilation and failed weaning rate are higher than in children, possibly allowing identification of risk factors using smaller numbers of patients.
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