More about the study

Methods

Objective: To reveal and describe the prevalence of demographic background and care provided for patients with PMV in PICUs.

Design: An international point prevalence study in PICU.

Setting: PICUs in multiple countries, including North and South America, and European and Asian countries.

Patients: Patients ≤ 18 years old who are on mechanical ventilation, with > 14 consecutive days (after 37 weeks postmenstrual age) of ventilation for more than 6 hours/day considering invasive ventilation and NIVs, on the day of the study. Patients with short interruptions (< 48 hours) of ventilation during the weaning process as the same episode of ventilation.

Measurements: Demographic data on included patients; their underlining disease and respiratory comorbidity leading/non-leading to PMV (e.g., prematurity, chronic lung disease, congenital heart disease), data on airway access, mechanical ventilation mode and parameters (i.e., invasive vs. non-invasive, other mode of ventilation including FIO2, duration of ventilation days), treatments (drugs used, invasive intravenous lines, feeding tubes), care unit where the patient admitted from prior to the PICU admission (e.g., NICU, general ward, who has been involved in the management), complications of mechanical ventilation will be collected.

Cirdularization: We will collect and record data via an online website case report form (eCRF) link using a secure web application. Each site investigators will have a secured username and password to access the eCRF.

Expecting Sample Size: We plan to conduct the study on isolated days three months apart for two years. We estimate that at least 2-5% of PICU-admitted cases require PMV. We estimate the prevalence of PMV in the PICUs are around 20%, which can give us 200 to 400 cases per study day from 50-100 participating centers.  

FUTURE CONSIDERATIONS

We believe that this study will provide valuable knowledge in regards PMV in critically ill children. This will help determine the need for a standardized approach or guide to those cohorts to lead better outcomes efficiently.

Lay Summary

Scientific advances, population growth, lower mortality, and increasing complexity of diseases have boosted up the number of patients requiring prolonged breathing assistance with mechanical ventilators in the pediatric intensive care units (PICU) in many parts of the developed world. Previous studies also suggest that there is a small group of children who actually need such a high level of support for extended periods of time, utilizing a lot of human and technical resources. We defined children with prolonged mechanical ventilation (PMV) if they required supports with a breathing machine for more than 14 days. We propose an international point prevalence study of children requiring PMV in PICU. We will conduct the study in multiple centers in several different regions, including North and South America, Europe, and Asian countries, with a strong relationship with local physician colleagues. Practice for patients requiring PMV will be examined including the type and size of local PICU, admission and discharge policies, and patient and treatment modalities administered to such patients, types of professionals looking after patients in PMV, types of health care. We anticipate a high variability in practices suggesting a need to further standardize the management of PMV.. Specifically, as an immediate consequence, by comparing and understanding the differences in patient demographics, practice details among PICUs in regards to the background factors of local PICUs and their patients, practitioners will share their way of dealing with such patients. In that way, this study will support the need to generate guidelines and lead to patient care improvement in PICUs.