Muhammad Haroon Hamid.
Basics of Mechanical Ventilation in Children - A Review.
Pak Paed J Jan ;42(1):3-15.

Mechanical ventilation has taken the cornerstone in modern critical care of children. It is one of the frequently used life support that needs clear understanding ? ensuring optimal care and minimising the risks and complications involved. In this review effort has been made to give an overview of the background and basics of artificial ventilation. The varying indications for which children are mechanically ventilated have been highlighted. The machines comes in all sort of sizes and models, however, one need to understand the basic principles and parameters used in these machines. Based on the underlying pathology and the indication of ventilation, an effort has been made to suggest initial settings that need to be started with while putting a child on ventilator. Once on the machine the adjustments are often done based primarily on two objective parameters ? hypoxemia and hypercapnia. A clear concept of potential complications would help in trouble shooting the acute problems and employing strategies to prevent these in short term or long term. Though art and science in itself, successful ventilation cannot be employed without support of other organ systems and without adjuvant therapies ? may it be nursing care, nutritional support or fluid and electrolyte balance. A fine line between continued ventilation and weaning from ventilation can be detrimental in so many ways. And lastly the story would not finish with discontinuation of artificial breathing, but the meticulous post extubation care is what will help early and safe discharge from ICU. This review is written keeping in view the needs of the beginners and district paediatricians, who may not have lot of experience in ventilating the children, but have an increasing need to learn the art and science of it.

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