title: Current trends in paediatric and neonatal ventilatory care -- a nationwide survey.
abstract: OBJECTIVE
  To assess daily practices in paediatric and neonatal ventilatory care in Finland.
  
  
  METHODS
  All neonatal and paediatric intensive care units in Finland were sent a questionnaire on ventilatory strategies and were offered a 3-month prospective survey.
  
  
  RESULTS
  A total of 96% of units returned the questionnaire, and clinicians agreed on most of the principles of lung-protective ventilation. Seventeen hospitals (94%) joined the prospective survey. On average, 2.3 new ventilation episodes were started daily, and totally 211 episodes were monitored. Pulmonary problems (64%) were the main cause of treatment in neonates and postoperative care (68%) in older children. Synchronized intermittent mandatory ventilation with pressure support was the primary mode in 42% of episodes. Hypocapnia was observed repeatedly in all units. In adult intensive care units, children often received high oxygen fraction, leading to hyperoxia, and they were frequently sedated with propofol, which is not licensed for that purpose. A large proportion of children had only light sedation or no sedation at all. Despite the different strategies and practices, most episodes resulted in a favourable outcome.
  
  
  CONCLUSIONS
  Most of the principles of lung-protective ventilation have been well accepted by clinicians. More attention should be paid to achieving normocapnia and normoxia and to the correct use of sedatives, especially in units that only occasionally provide paediatric ventilation.
authors.affiliation: Department of Pediatrics, Oulu University Hospital, Oulu, Finland. merja.alander@oulu.fi
authors.forename: Merja
authors.initials: M
authors.lastname: Ålander
authors.forename: Outi
authors.initials: O
authors.lastname: Peltoniemi
authors.forename: Timo
authors.initials: T
authors.lastname: Saarela
authors.forename: Eija
authors.initials: E
authors.lastname: Anttila
authors.forename: Tytti
authors.initials: T
authors.lastname: Pokka
authors.forename: Tero
authors.initials: T
authors.lastname: Kontiokari
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends*; D005387:Finland; D005500:Follow-Up Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data / Q000639:trends; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data / Q000639:trends*; D010043:Outcome and Process Assessment, Health Care; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends*; D011795:Surveys and Questionnaires; D055397:Ventilator-Induced Lung Injury / Q000517:prevention & control