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Introduction: Spontaneous breathing trials (SBTs) are recommended as a routine practice in mechanical ventilation management in pediatric critical care. However, there are multiple ways to perform this assessment, with no ideal standard. Objectives: To describe the range of available SBT protocols and/or processes reported in the literature, including their screening and assessment criteria, and implementation processes. Inclusion criteria: Studies describing SBT screening/eligibility, testing methods, pass/fail criteria and/or other pertinent details surrounding SBT will be included. Eligible citations will include in pediatric patients (i.e., aged 0 to 18 years) admitted to the pediatric intensive care unit. All primary research studies, letters and/or commentary, abstracts only, study protocols, text and opinion papers, and grey literature will be included if they contain data that meet the scoping review objectives. Secondary research studies, and knowledge syntheses will be excluded, however the references will be screened for inclusion. Studies mainly assessing patients who do not typically qualify for SBTs will be excluded e.g., long-term mechanical ventilation, intubated for elective procedures only. Studies on the premature infant/neonatal population will be excluded. Studies with mixed populations will be included only if >80% of the sample is pediatric and/or pediatric data is reported separately. Methods: This scoping review will be conducted using the Joanna Briggs Institute’s (JBI) methodology. Medline, EMBASE, Cochrane and CINAHL will be searched using a strategy developed by a health librarian. Citation abstract screening, full-text review, and data extraction will be done using Covidence software by two independent reviewers, with third reviewer arbitration where necessary. Grey literature, clinical trial registries, pre-print databases, and pediatric ventilation networks will be explored for available, approved SBT protocols. Using a standardized pilot tested data extraction form, a description of the studies, and SBT and implementation processes will be collected. Data will be presented using both numeric and descriptive summaries, describing any patterns related to the SBT process(es) in tables and figures. If possible, differences in SBT processes will be described between different characteristics, such as size of units, and geographic regions. Quality/completeness of study SBT reporting will be assessed and described. |
