The pediatric mechanical ventilation in Canada (PeMViC) study: A Delphi survey of pediatric mechanical ventilation practices by Canadian respiratory therapists

Abstract

The gap in knowledge for pediatric mechanical ventilation (MV) management makes practice standardization difficult. The European Society for Pediatric and Neonatal Intensive Care (ESPNIC) was the first to establish consensus recommendations on pediatric MV management. In Canada, respiratory therapists (RTs) have a large role in MV management, but do not exist in Europe. The purpose was to determine Canadian RTs’ recommendations on common pediatric MV management. An e-Delphi study included n=56 participants from 15 Canadian pediatric facilities. All statements achieved consensus and this guideline consists of 59 recommendations, organized into 10 subsections: Non-invasive ventilation; tidal volumes and inspiratory pressures; respiratory rate and inspiratory time; PEEP and FiO2; Advanced Mechanical Ventilation; Weaning; Physiologic Targets; Monitoring; General MV practice and Equipment adjuncts. These commonly practiced pediatric MV techniques by RTs may be used as a standard for future clinical practice and studies to understand their clinical impact in critically ill children.