Evidence map›Paper›PMID 36563873›Full record

GuidelineChest2023

Operational Definitions Related to Pediatric Ventilator Liberation.

Samer Abu-Sultaneh, Narayan Prabhu Iyer, Analía Fernández, Michael Gaies, Sebastián González-Dambrauskas, Justin Christian Hotz, Martin C J Kneyber, Yolanda M López-Fernández, Alexandre T Rotta, David K Werho and 21 more

Open access · bronzeAbstract readPractice Guideline
In one paragraph

Guideline in Chest, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 3 pooled it
4.7field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 34 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors at 20 institutions in 11 countries.

Samer Abu-SultanehDivision of Pediatric Critical Care, Department of Pediatrics Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, Indianapolis, IN. Electronic address: sultaneh@iu.edu.
Narayan Prabhu IyerFetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Analía FernándezPediatric Critical Care Unit, Hospital General de Agudos "C. Durand" Ciudad Autónoma de Buenos Aires, Argentina.
Michael GaiesDepartment of Pediatrics, Division of Pediatric Cardiology, University of Cincinnati College of Medicine, and Cincinnati Children's Hospital Medical Center Heart Institute, Cincinnati, OH.
Sebastián González-DambrauskasRed Colaborativa Pediátrica de Latinoamérica (LARed Network) and Departamento de Pediatría Unidad de Cuidados Intensivos de Niños del Centro Hospitalario Pereira Rossell, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
Justin Christian HotzDepartment of Anesthesiology and Critical Care, Children's Hospital Los Angeles, Los Angeles, CA.
Martin C J KneyberDepartment of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Yolanda M López-FernándezDepartment of Pediatrics, Pediatric Critical Care Division, Cruces University Hospital, Biocruces-Bizkaia Health Research Institute, Bizkaia, Spain.
Alexandre T RottaDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Duke University, Durham, NC.
David K WerhoDivision of Pediatric Cardiology, Cardiothoracic Intensive Care, UC San Diego, Rady Children's Hospital, San Diego, CA.
Arun Kumar BaranwalDepartment of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Bronagh BlackwoodWellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom.
Hannah J CravenRuth Lilly Medical Library, Indiana University School of Medicine, Indianapolis, IN.
Martha A Q CurleyFamily and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA; Research Institute, Children's Hospital of Philadelphia, Philadelphia, PA.
Sandrine EssouriDepartment of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Montreal, QC, Canada.
Jose Roberto FiorettoDepartment of Pediatrics, Pediatric Critical Care Division, Botucatu Medical School-UNESP-São Paulo State University, Botucatu, SP, Brazil.
Silvia M M HartmannDivision of Critical Care Medicine, Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, WA.
Philippe JouvetDepartment of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Montreal, QC, Canada.
Steven Kwasi KorangDepartment of Anesthesiology and Critical Care, Children's Hospital Los Angeles, Los Angeles, CA; Copenhagen Trial Unit, Centre for Clinical Intervention Research, The Capital Region of Denmark, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Gerrard F RaffertyCentre for Human and Applied Physiological Sciences, Faculty of Life Sciences & Medicine, King's College London, London, England.
Padmanabhan RamnarayanDepartment of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England.
Louise RoseFlorence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, England.
Lyvonne N TumeEdge Hill University Health Research Institute, Ormskirk, England.
Elizabeth C WhippleRuth Lilly Medical Library, Indiana University School of Medicine, Indianapolis, IN.
Judith Ju Ming WongKK Women's and Children's Hospital, Singapore.
Guillaume EmeriaudDepartment of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Montreal, QC, Canada.
Christopher W MastropietroDivision of Pediatric Critical Care, Department of Pediatrics Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, Indianapolis, IN.
Natalie NapolitanoRespiratory Therapy Department, Children's Hospital of Philadelphia, Philadelphia, PA.
Christopher J L NewthDepartment of Anesthesiology and Critical Care, Children's Hospital Los Angeles, Los Angeles, CA; Department of Anesthesiology and Critical Care, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA.
Robinder G KhemaniDepartment of Anesthesiology and Critical Care, Children's Hospital Los Angeles, Los Angeles, CA; Department of Anesthesiology and Critical Care, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA.
Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network
Centre Hospitalier Universitaire Sainte-Justine · CAUniversity of Southern California · USChildren's Hospital of Los Angeles · USChildren's Hospital of Philadelphia · USIndiana University Health · USIndiana University School of MedicineKing's College London · GBBioCruces Health research Institute · ESCincinnati Children's Hospital Medical Center · USDuke University · USEdge Hill University · GBEl Hospital General de Agudos Carlos G. Durand · ARImperial College London · GBKK Women's and Children's Hospital · SGPost Graduate Institute of Medical Education and Research · INQueen's University Belfast · GBSeattle Children's Hospital · USUniversidad de la República de Uruguay · UYUniversidade Estadual Paulista (Unesp) · BRUniversity Medical Center Groningen · NL

Funding

Pediatric Ventilator Liberation Consensus ConferenceR13HD102137 · NICHD · CHILDREN'S HOSPITAL OF LOS ANGELES · PI ABU-SULTANEH, SAMER, KHEMANI, ROBINDER · 2020 to 2021
$75k
NICHD NIH HHS R13 HD102137
6 · The paper itself

Abstract

backgroundCommon, operational definitions are crucial to assess interventions and outcomes related to pediatric mechanical ventilation. These definitions can reduce unnecessary variability among research and quality improvement efforts, to ensure findings are generalizable, and can be pooled to establish best practices. RESEARCH QUESTION: Can we establish operational definitions for key elements related to pediatric ventilator liberation using a combination of detailed literature review and consensus-based approaches? STUDY DESIGN AND

methodsA panel of 26 international experts in pediatric ventilator liberation, two methodologists, and two librarians conducted systematic reviews on eight topic areas related to pediatric ventilator liberation. Through a series of virtual meetings, we established draft definitions that were voted upon using an anonymous web-based process. Definitions were revised by incorporating extracted data gathered during the systematic review and discussed in another consensus meeting. A second round of voting was conducted to confirm the final definitions.

resultsIn eight topic areas identified by the experts, 16 preliminary definitions were established. Based on initial discussion and the first round of voting, modifications were suggested for 11 of the 16 definitions. There was significant variability in how these items were defined in the literature reviewed. The final round of voting achieved ≥ 80% agreement for all 16 definitions in the following areas: what constitutes respiratory support (invasive mechanical ventilation and noninvasive respiratory support), liberation and failed attempts to liberate from invasive mechanical ventilation, liberation from respiratory support, duration of noninvasive respiratory support, total duration of invasive mechanical ventilation, spontaneous breathing trials, extubation readiness testing, 28 ventilator-free days, and planned vs rescue use of post-extubation noninvasive respiratory support.

interpretationWe propose that these consensus-based definitions for elements of pediatric ventilator liberation, informed by evidence, be used for future quality improvement initiatives and research studies to improve generalizability and facilitate comparison.

Indexed as

Respiration, ArtificialVentilator WeaningAirway ExtubationChildHumansResearch DesignVentilators, Mechanicalairway extubationextubation failurehigh-flow nasal cannulamechanical ventilationnoninvasive ventilationpediatric ICUventilator weaning

Identifiers

PMID36563873
PMCPMC10206507
OpenAlexW4312084950

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.