Consensus Statements

Mechanical Ventilation: Beyond the ICU
Quick Reference Guide

TOC | Previous | Next

Ventilation Techniques

Positive pressure ventilation via tracheostomy is the usual method of assisted ventilation in infants and young children.

Commercially available positive pressure home care ventilators may have device specifications that limit their application to infants and small children. Equipment must be evaluated to assure efficacy, adequacy, and safety for infants and children.

Positive pressure ventilation via nasal mask can sometimes be used in older children, but it is cumbersome for children requiring full-time ventilation.

Negative pressure ventilation via chest shell or body wrap is not ideally adaptable to infants and young children due to unique upper airway anatomy, and young children may be fearful of a tank's confinement. Negative pressure technique may be ideal for some older children with neuromuscular disorders or transient respiratory failure if the technique makes a tracheostomy unnecessary.

Diaphragm pacing should be managed by centers with experience in the technique and dedicated interdisciplinary teams.

Rocking beds and pneumobelts are not recommended for infants. Pneumobelts may be useful in daytime support of older children.

When children are ventilated from infancy, some may develop chronic pulmonary disease of variable severity that is generally characterized by reactive airway disease. The etiology is unclear. Pulmonary disease often improves at age 5 to 10 years or later, but lungs may not be entirely normal.

Modes of Ventilation

For infants and small children, modes of ventilation should be limited in number and simple to implement.

TOC | Previous | Next

3300 Dundee Road • Northbrook, Illinois 60062-2348 • (847) 498-1400 • (800) 343-2227
Copyright ©1999-2008 American College of Chest Physicians. All Rights Reserved.
ACCP Privacy Policy | ACCP Web Site Terms of Use