What's new in paediatric ventilator liberation?

Between 40 and 65% of children admitted to paediatric intensive care units (PICUs) require invasive mechanical ventilation (IMV) [1]. Although IMV can be lifesaving, prolonged IMV is associated with serious risks such as exposure to sedative medications, ventilator-associated events, and ventilator-induced lung injury [2]. Premature ventilator liberation can however be associated with extubation failure and associated adverse outcomes [3]. There has traditionally been a scarcity of high-quality evidence to guide ventilator liberation practice in children [4]; however, in recent years, randomised clinical trial (RCT) evidence has emerged. In this article, we review the latest literature on paediatric ventilator liberation using the conceptual framework shown in Fig. 1.