Critical Care

official impact factor 4.60

Commentary

Prediction of ventilation weaning outcome: children are not little adults

Margrid B Schindler

Author Affiliations

Consultant in Paediatric Intensive Care, Paediatric Intensive Care Unit, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, United Kingdom

Critical Care 2005, 9:651-652 doi:10.1186/cc3950

Published: 25 November 2005

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.