Invasive mechanical ventilation is prevalent and associated with significant morbidity. Pediatric critical care teams must identify the best timing and approach to liberating (extubating) children from this supportive care modality. Unsurprisingly, practice variation is significant. As a first step to minimizing that variation, the first evidence-based Pediatric Ventilator Liberation Guidelines were published in 2023 and included 15 recommendations. Unfortunately, there is often a substantial delay before clinical guidelines reach widespread clinical practice. As such, it is important to consider barriers and facilitators using a systematic approach during implementation planning and design. In this narrative review, we will 1) summarize guideline recommendations, 2) discuss recent evidence and identify practice gaps relating to those recommendations, and 3) hypothesize about potential barriers and facilitators to their implementation in clinical practice.

中文翻译：

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使用最新证据实施儿科呼吸机解放指南：叙述性审查。


有创机械通气很普遍，并且与显着的发病率相关。儿科重症监护团队必须确定将儿童从这种支持性护理方式中解放出来（拔管）的最佳时机和方法。毫不奇怪，实践差异很大。作为最大限度减少这种差异的第一步，第一个基于证据的儿科呼吸机解放指南于 2023 年发布，其中包括 15 条建议。不幸的是，临床指南在广泛应用于临床之前往往会出现相当长的延迟。因此，在实施规划和设计期间使用系统方法考虑障碍和促进因素非常重要。在这篇叙述性综述中，我们将 1) 总结指南建议，2) 讨论最近的证据并确定与这些建议相关的实践差距，3) 假设其在临床实践中实施的潜在障碍和促进因素。