Knowledge of paediatric mechanical ventilation is moving forward at an interesting pace. There are no clear or consistent guidelines despite several years of mechanical ventilation on a large number of paediatric populations. Although, the basic principles of physics and gas flow apply to all age groups, anatomical and physiological differences in children play a significant role in selecting the type of ventilator as well as the ventilatory modes and settings. Requirement for respiratory support in children admitted to ICU is common. Respiratory failure or impending failure is usually due to lung pathology or other systemic disease contributing to respiratory compromise. Monitoring vital signs, blood gases, pulse oximeter and end-tidal carbon dioxide are essential to provide optimal care. Positive pressure ventilation with improper settings may result in barotrauma and it is essential to prevent or detect these complications at the earliest.
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