Protocols to help with triage of mechanical ventilation for pediatric patients during a pandemic
Citation: Kim KM, Cinti S, Gay S, et al. Triage of mechanical ventilation for pediatric patients during a pandemic. Disaster Medicine and Public Health Preparedness 2012 6(2): 131-7
What is this? Some patients with COVID-19 will develop respiratory failure and need help with their breathing. This might be provided by mechanical ventilation (MV) in an intensive care unit (ICU), but these resources may become limited during a pandemic. Methods might be needed to triage patients to allocate access to these resources and this review examined these for pediatric patients.
In this systematic review, the authors searched for studies evaluating critical care prognosis and multisystem organ failure scoring systems for children under 18 years of age. They restricted their searches to articles published in English and did these up to February 2010. They identified 22 reports of five independently derived scoring systems for use in a protocol for MV triage in a pandemic.
What works: The evidence in the review is that, of the possible scoring systems applicable for the generalized pediatric critical care population, the only score that fulfilled all criteria required for use as a ventilator triage tool for children during a respiratory pandemic is the Pediatric Logistic Organ Dysfunction (PELOD) score.
What doesn’t work: Nothing noted.
What’s uncertain: Nothing noted.