The 2007 International Consensus Conference Definition in ventilated
pediatric patients
Abstract
Background The Task Force classification (TFC) identifies weaning from
mechanical ventilation (MV) in adults as: simple (SW), difficult (DW)
and prolonged (PW). The usefulness of this classification is unknown in
pediatric patients. Methods Prospective, descriptive, multicenter study
in 29 pediatric intensive care units from Argentina during a three-month
period including all admitted patients who required MV and met weaning
criteria. The evolution of these patients was analyzed according to TFC.
Results 474 patients were included, 454 (95.8 %) of whom were
successfully extubated. Eighty percent (n=370) were extubated after the
first attempt and classified as SW, 84 (18,2%) were DW and only 7
(1,5%) faced a PW. Successful extubation on the first trial was 77.9%
(n=356) and for subsequent trials, 56.7%, 64.5% and 66.7%. The
duration of MV (in days) by group was [median (interquartile
range)]: 5.4 (2.8-9.7) (SW), 10.6 (7.7-18.8) (DW) and 27.4 (15.1-28.4)
(PW). Fourteen patients underwent tracheostomy without any weaning
attempt, 3 patients were on MV at the end of the study and 3 patients
died without any attempt. The only variable associated with PW and DW
(as a single group, with SW as reference) in multivariable analysis was
ventilator-associated pneumonia (OR 2.58, 95%CI 1.01-6.11). Conclusions
We observed a low prevalence of PW. Patients with PW and DW showed no
significant differences from patients with SW, albeit a higher incidence
of VAP.