measuring-inspiratory-effort-in-mechanically-ventilated-children

Measuring Inspiratory Effort In Mechanically Ventilated Children

An accurate assessment of inspiratory effort in mechanically ventilated children is essential for optimizing ventilator support and avoiding lung- and ...

The Hospital for Sick Children

Extubation failure (EF) in neonates recovering from congenital cardiac surgery is associated with morbidity and mortality. Adding continuous physiologic monitoring data and risk analytics algorithms to clinical factors has the potential to assist clinicians in identifying those neonates at high risk for EF. We aimed to evaluate the association of two physiologic risk analytics algorithms evaluating the probability of inadequate delivery of oxygen index (ID o2 ) and inadequate ventilation of carbon dioxide index (IV co2 ) with EF in neonates receiving mechanical ventilation (MV) after cardiac surgery. A secondary aim was to evaluate the clinical factors associated with EF.

Extubation Failure in Neonates Following Congenital Cardiac Surgery: Multicenter Retrospective Cohort, 2017-2020.

 Teaching competence is expected of all intensivists, yet experts rarely supervise or assess trainees' teaching skills. Simulation offers an attractive solution.  Develop and validate a simulation-based assessment of clinical teaching skills in pediatric critical care medicine (CCM).  Participants were 128 pediatric CCM trainees, registered nurses, and respiratory therapists. Medical education experts used literature review and consensus to design three scenarios to assess teaching skills. Scenarios were piloted before use, and raters were trained. Teams completed one of three teaching scenarios, followed by a communication scenario. Raters were faculty members and trainees. Evidence for validity was collected and analyzed using Messick's unifying framework under the following domains: content, response processes, internal structure, relationship to other variables, and consequences of the assessment.  The scenarios and assessment tools were designed to capture the characteristics of a good teacher as described in the literature. Raters provided feedback that the tools were easy to use. Internal consistency of the scores measured by Cronbach's α was high. Rater agreement measured by interclass correlation was moderate for one of three scenarios. The relationship to other variables was investigated by correlating teaching scores with communication. Pearson's correlation was moderate for two of three scenarios. Consequences evidence was gathered using a retrospective self-assessed learning gain before versus after the training, which was significant for all scenarios.  We developed a three-station simulation program for the assessment of teaching skills in pediatric CCM. The validity evidence collected is moderate, which indicates that it is effective for training and feedback on teaching skills.

Development and Validity of a Simulation Program for Assessment of Clinical Teaching Skills.

The use of risk analytics indices alongside clinical factors has potential to assist clinicians in identifying children at high risk for extubation failure (EF). We investigated the association of two physiologic risk analytics indices with EF in children receiving mechanical ventilation (MV) after cardiac surgery: the probability of inadequate oxygen delivery (ID o2 ) and inadequate ventilation of carbon dioxide index (IV co2 ). A secondary aim was to evaluate clinical factors associated with EF.

Clinical and Risk Analytics Associations With Extubation Failure in Children Following Congenital Cardiac Surgery: A Multicenter Retrospective Cohort Study, 2017-2020.

The use of post-extubation respiratory support in single-ventricle neonates undergoing the Norwood procedure is poorly described. We investigated the patterns of respiratory support following extubation as well as factors associated with prolonged exposure to post-extubation noninvasive respiratory support (NRS), defined as greater than or equal to 72 hours, in neonates recovering from the Norwood procedure.

Associations With Prolonged Post-Extubation Noninvasive Respiratory Support in Neonates Following the Norwood Procedure: A Two-Center Retrospective Cohort Study, 2019-2023.

Article	Year
Extubation Failure in Neonates Following Congenital Cardiac Surgery: Multicenter Retrospective Cohort, 2017-2020. Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies\| PubMed ID: 39927824	2025
Development and Validity of a Simulation Program for Assessment of Clinical Teaching Skills. ATS scholar\| PubMed ID: 40393078	2025
Clinical and Risk Analytics Associations With Extubation Failure in Children Following Congenital Cardiac Surgery: A Multicenter Retrospective Cohort Study, 2017-2020. Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies\| PubMed ID: 40736342	2025
Associations With Prolonged Post-Extubation Noninvasive Respiratory Support in Neonates Following the Norwood Procedure: A Two-Center Retrospective Cohort Study, 2019-2023. Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies\| PubMed ID: 41705886	2026

Luciana Rodriguez Guerineau

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