[Weaning from invasive mechanical ventilation in pediatric patients (excluding premature neonates)]

Arch Pediatr. 2010 Apr;17(4):399-406. doi: 10.1016/j.arcped.2010.01.017. Epub 2010 Mar 12.
[Article in French]


The process of weaning from mechanical ventilation (WMV) is the same in children as in adults. In the pediatric literature, weaning failure rate ranges from 1.4 to 34%. So far, no indices of weaning success have been demonstrated to be sufficiently accurate. The criteria for assessing readiness to wean, which must be screened daily, have neither been validated nor adapted to the pediatric population. The spontaneous breathing test (SBT), the reference screening test for weaning, precedes extubation; it can be achieved with pressure support ventilation or spontaneous breathing (T piece or canopy or flow-inflating bag). A standardized weaning protocol (which can be computer driven) was used in only three pediatric studies and the impact on shortening the duration of mechanical ventilation has not yet been demonstrated. It should be paired with a sedative interruption protocol. Weaning criteria, SBT criteria, and/or protocol tolerance are guides, but clinicians must individualize decisions to use these criteria. The use of noninvasive ventilation is increasing and its place in weaning protocols for children needs to be determined; it might modify the definitions of weaning failure and weaning success in the future.

Publication types

  • Case Reports
  • Consensus Development Conference

MeSH terms

  • Adult
  • Child
  • Child, Preschool
  • Humans
  • Hypoxia / physiopathology
  • Hypoxia / therapy
  • Infant
  • Oxygen / blood
  • Oxygen Inhalation Therapy
  • Prognosis
  • Respiration, Artificial / methods
  • Respiratory Insufficiency / physiopathology
  • Respiratory Insufficiency / therapy*
  • Therapy, Computer-Assisted
  • Ventilator Weaning / methods*
  • Work of Breathing / physiology


  • Oxygen