Support of respiratory failure in the pediatric surgical patient.
Severe respiratory failure in newborn and pediatric patients is associated with significant morbidity and mortality. Basic science laboratory investigation has led to advances in the understanding of ventilator-induced lung injury and in optimizing the supportive use of conventional ventilation strategies. Over the past few years, progress has been made in alternative therapies for supporting children and adults with severe respiratory failure. This review will focus on recent laboratory and clinical data regarding the techniques of lung protective ventilator strategies, inhaled nitric oxide, liquid ventilation, and extracorporeal life support (ECLS, ECMO). Some of these modalities are commonplace, while others may have much to offer the pediatric clinician if their benefit is clearly demonstrated in future clinical trials.
Section of Pediatric Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA. rhirschl@umich.edu
Ronald B
RB
Hirschl
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy*; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D012122:Ventilators, Mechanical / Q000009:adverse effects*