Ventilator Settings in Critically Ill Pediatric Patients (VESPer)—insights from a European Registry

Abstract Aim To explore ventilator settings, ventilation variables and parameters in critically ill pediatric patients across European Centers. Methods International, multicenter, prospective observational study, collecting ventilation data for 7 days from patients aged ≤ 12 years, requiring ventilatory support for ≥ 12 h. Primary endpoint was a set of key ventilator settings, including tidal volume (V T ), respiratory rate (RR), peak and mean airway pressure (Ppeak and Pmean), positive end–expiratory pressure (PEEP), and the fraction of inspired oxygen (FiO 2 ). Ventilator settings were compared across neonates (aged < 1 month), infants (1 to 12 months), toddlers (1 to 3 years) and children (4 to 12 years), and between patients with and without pediatric acute respiratory distress syndrome (PARDS). Results Patients enrolment occurred in 43 centers in 11 countries, with a total of 166 patients—mostly infants—included in this analysis. The majority began with invasive ventilation, while one–third started with noninvasive ventilation (NIV) or high–flow nasal oxygen (HFNO). Patients on invasive ventilation, NIV and HFNO were weaned within a median of 3 [2–6], 3 [2–4] and 3 [2–4] days, respectively. In 22% of patients, NIV or HFNO was used following invasive ventilation. V T , RR and FiO 2 varied across age groups, and airway pressures were higher in PARDS patients. Conclusions In this cohort, ventilator settings, and ventilation variables and parameters, varied between individual patients and across patient groups. Larger studies are needed to confirm this variability, explore associations between ventilation practices and clinical outcomes, and assess temporal and geo–economic differences.

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Publication Details

Journal
Intensive Care Medicine – Paediatric and Neonatal
Published
2025-04-07
DOI
https://doi.org/10.1007/s44253-025-00069-2
Citations
1
Primary Topic
Respiratory Support and Mechanisms
Type
article
Field-Weighted Citation Impact
1.52
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article

Ventilator Settings in Critically Ill Pediatric Patients (VESPer)—insights from a European Registry

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Respiratory Support and Mechanisms
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article

Ventilator Settings in Critically Ill Pediatric Patients (VESPer)—insights from a European Registry

Relin van Vliet, Jesús López‐Herce, Elena Álvarez-Rojas, Sylvain Renolleau, A Villaneuva, Louise Rose, Marloes M. IJland, Frederique Paulus, Mireia Garcia Cusco, Paul Wellman, Marcus Josephus Schultz, Cecilia Korb, Fabrizio Chiusolo, Alexandra Dinis, Ayşe Berna Anıl, Merja Kallio, Eider Oñate Vergara, Cristina Calvo, Martin C. J. Kneyber, Lyvonne N. Tume, Paula Rocha, Carla Pinto, Ana María Llorente de la Fuente, Antonio Pérez Ferrer, Marcel Tinnevelt, Bronagh Blackwood, Cristina Camilo, Anita Duyndam, Danièle De Luca, Oliver Karam, Ebru Atike Ongun, David Arjona Villanueva, Jean‐Michel Liet, Julia Harris, Çağlar Ödek, Teresa Gili Bigatá, Yolanda M. López‐Fernández, Clara Abadesso, Jorge López, P. Madurga Revilla, Anna Dehò, J. Pilar Orive, Jozef De Dooy, Duncan Macrae, Mathieu Genuini, M. Pons, Reinout J. Mildner, Joris Lemson, Florent Baudin, Robert G. T. Blokpoel, Nurettin Onur Kutlu, Vicent Modesto i Alapont, Peter P. Roeleveld, Sandra Dijkstra, Claire-Marie Barbier, Elaine Scott, Aldona Pietrzak, Angela Lawton-Woodhall, Alicja Bartkowska‐Śniatkowska, J.S. Parrilla Parrilla, Sonia Pelluau, Carlos Escobar, Outi Peltoniemi, Pablo del Villar Guerra, Joana Sofia Correia, Birthe J. Gesink-van der Veer, Pierre-Louis Léger, Matthieu Maria, David M. P. van Meenen, Lee Ferguson, María José Arroyo-Marín, Yasemin Ataman, Corinna Karsten-Waagmeester, G. Justin M. Woerlee, Nicolas Roullet-Renolleau
article en
1 citations

Abstract

Abstract Aim To explore ventilator settings, ventilation variables and parameters in critically ill pediatric patients across European Centers. Methods International, multicenter, prospective observational study, collecting ventilation data for 7 days from patients aged ≤ 12 years, requiring ventilatory support for ≥ 12 h. Primary endpoint was a set of key ventilator settings, including tidal volume (V T ), respiratory rate (RR), peak and mean airway pressure (Ppeak and Pmean), positive end–expiratory pressure (PEEP), and the fraction of inspired oxygen (FiO 2 ). Ventilator settings were compared across neonates (aged < 1 month), infants (1 to 12 months), toddlers (1 to 3 years) and children (4 to 12 years), and between patients with and without pediatric acute respiratory distress syndrome (PARDS). Results Patients enrolment occurred in 43 centers in 11 countries, with a total of 166 patients—mostly infants—included in this analysis. The majority began with invasive ventilation, while one–third started with noninvasive ventilation (NIV) or high–flow nasal oxygen (HFNO). Patients on invasive ventilation, NIV and HFNO were weaned within a median of 3 [2–6], 3 [2–4] and 3 [2–4] days, respectively. In 22% of patients, NIV or HFNO was used following invasive ventilation. V T , RR and FiO 2 varied across age groups, and airway pressures were higher in PARDS patients. Conclusions In this cohort, ventilator settings, and ventilation variables and parameters, varied between individual patients and across patient groups. Larger studies are needed to confirm this variability, explore associations between ventilation practices and clinical outcomes, and assess temporal and geo–economic differences.

Intensive Care Medicine – Paediatric and NeonatalVol. 3(1)
University Medical Center Groningen (NL), Mahidol University (TH), University of Oxford (GB), Mahidol Oxford Tropical Medicine Research Unit (TH), Amsterdam University Medical Centers (NL), Medical University of Vienna (AT), University of Amsterdam (NL)
Openalex Percentile: Top 20%
Respiratory Support and Mechanisms
1.52
DOIOpen Access PDFOpenAlex
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