Zinc-Jack of all trades, master of none!
Zinc-Jack of all trades, master of none!
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锌杰克万事通，无一不是大师！
DOI：
10.1097/pcc.0b013e3181937657
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Aneja,RajeshK
中科院分区：
文献类型：
--
作者：
Aneja,RajeshK
To paraphrase author Stephen Covey, management of the child with respiratory failure should ideally begin with the end in mind. Liberating the child from the ventilator is the ultimate end game of mechanical ventilation. A significant body of work has been undertaken by investigators seeking when and how to most effectively wean and extubate pediatric patients. In this issue of Pediatric Critical Care Medicine, Newth et al (1) with the National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network provide an assessment of the literature to date on the state of the art of weaning children from ventilation. They provide an excellent overview of the questions and a reminder that significant work remains to reach certainty in determining optimal modes of ventilator support for weaning and extubation. The authors address research in three basic areas of study: optimal approaches to weaning, clinical markers for predicting successful extubation, and adjunctive therapies to ensure successful extubation. They concluded as follows:1) Optimal weaning method: No specific form of ventilation has demonstrated more rapid and successful time to extubation. Protocol-based approaches to weaning could have potential benefit in advancing readiness to extubate but also have not shown significant outcome difference. 2) Clinical markers of extubation success: No specific physiologic indicator has been found to predict extubation success in children. However, a daily assessment trial of readiness to extu-
