Ventilation

Weaning from Ventilation

Patients require mechanical ventilation with an artificial airway for many reasons. However, regardless of the reason, as the patient’s condition stabilises and begins to show signs of improvement, attention should shift to the weaning process.
The weaning process is an essential part of ventilator management that requires a balanced approach. On the one hand, failure to recognise when the patient is ready to wean will result in exposure to risks from excessive sedation, lung injury, and infection. On the other hand, overly aggressive weaning attempts also exposes the patient to risks from muscle fatigue, aspiration and compromised gas exchange. For this reason, the EfCCNa recommends that European nurses should actively participate in the weaning process and the following documents provide evidence based information to inform and support weaning practice.

• EfCCNa Position Statement on Nurses' Role in Weaning from Ventilation  (2012)
  
  
• Rules for the road to recovery: factors affecting the use of protocols for ventilation weaning in intensive care - evidently Cochrane  
  
  
• Automated versus non-automated weaning for reducing the duration of mechanical ventilation for critically ill adults and children (Review)    Rose L, Schultz MJ, Cardwell CR, Jouvet P, McAuley DF, Blackwood B. The Cochrane Library 2013 Issue 6
  
  
• Protocolized versus non-protcolized weaning for reducing the duration of mechanical ventilation for critically ill adults and children (Review)    Blackwood B, Alderdice F, Burns KEA, Cardwell CR, Lavery G, O'Halloran P, The Cochrane Library 2012, Issue 11
  
  
• Decisional responsibility for mechanical ventilation and weaning: an international survey
  Rose et al, Critical Care 2011 1 5:R295

Ventilator Associated Pneumonia (VAP)

• Recommendations on the prevention of VAP
• Preventing VAP in Children: an Evidence-Based Protocol

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Nursing Care of the Ventilated Patient

• A comprehensive Review of Pediatric Endotracheal Suctioning: Effects, Indication and Clinical Practice

Non Invasive Ventilation

Non invasive Ventilation in Pediatrics.  A. Medina, M. Pons, F. Martinon-Torres; © 2009 by Ergon ISBN: 978-84-8473-757-5

The aim of this second edition of “Non-invasive Ventilation in Pediatrics” was to incorporate all of the knowledge accumulated in the past four years. Nonetheless, due to the limited body of literature on NIV, there are many aspects of this treatment that are dictated primarily by experience and by each author’s opinion.

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