Outcomes of Unplanned Extubations in a Large Children's Hospital.

Background: Unplanned extubation (UE) is defined as unintentional dislodgement of an endotracheal tube (ETT) from the trachea. UEs can lead to instability, cardiac arrest, and may require emergent tracheal re-intubation. As part of our hospital-wide quality improvement (QI) work, a multidisciplinary committee reviewed all UEs to determine contributing factors and evaluation of clinical outcomes to develop QI interventions aimed to minimize UEs.

Utilizing Competence-Based Simulation to Improve Orientation Outcomes.

Background: New graduate respiratory therapists (RTs), regardless of the degree program, receive limited preparation in neonatal/pediatric diseases and management. Experienced RTs typically have adult knowledge but limited exposure to pediatrics. We developed a program that included competence-based simulation to improve orientation success.

High frequency percussive ventilation in pediatric acute respiratory failure.

Objective: High frequency percussive ventilation (HFPV) is used in acute respiratory failure, but is poorly described in pediatrics. We aimed to describe the clinical characteristics, ventilator settings, and outcomes of a large pediatric cohort, and to determine predictors of who would benefit from HFPV.

Hypothesis: Gas exchange 2 h after HFPV initiation predicts success.

Ventilator-Weaning Pathway Associated With Decreased Ventilator Days in Pediatric Acute Respiratory Distress Syndrome.

Objectives: There is limited evidence on the impact of protocolized ventilator weaning in pediatric acute respiratory distress syndrome, despite utilization in clinical trials and clinical care. We aimed to determine whether protocolized ventilator weaning shortens mechanical ventilation duration and PICU length of stay in pediatric acute respiratory distress syndrome survivors.

Design: Secondary analysis of a prospective pediatric acute respiratory distress syndrome (Berlin definition) cohort from July 2011 to June 2019 analyzed using interrupted time series analysis pre- and postimplementations of a ventilator-weaning pathway.

High-frequency percussive ventilation and bronchoscopy during extracorporeal life support in children.

Variables affecting duration of pediatric extracorporeal life support (ECLS) are poorly defined. Prior analyses suggested increased mortality risk with prolonged ECLS. Lung recruitment strategies with improved secretion mobilization may shorten ECLS duration.

High-frequency percussive ventilation improves oxygenation and ventilation in pediatric patients with acute respiratory failure.

Purpose: High-frequency percussive ventilation (HFPV) in pediatrics has been described predominantly in burned patients. We aimed to describe its effectiveness and safety in noninhalational pediatric acute respiratory failure (ARF).

Methods: We conducted an observational study in a tertiary care pediatric intensive care unit on 31 patients with ARF failing conventional ventilation transitioned to HFPV.