Ventilação não invasiva em unidades de terapia intensiva pediátrica: um protocolo de revisão de escopo

Abstract

Non-invasive ventilation has been widely used in pediatric intensive care units as a ventilatory support strategy in children with respiratory failure, aiming to reduce the need for intubation and its associated complications. This study aims to map and synthesize the available evidence regarding non-invasive ventilation protocols applied in this context, with emphasis on the criteria for indication and discontinuation, parameters used, clinical outcomes, and barriers to its implementation. The research question was developed based on the PCC (Population, Concept, and Context) strategy, in which the population comprises children and adolescents up to 17 years of age undergoing non-invasive ventilation in pediatric intensive care units, the concept refers to non-invasive ventilation protocols, including physiotherapy strategies, ventilatory parameters, criteria for indication and discontinuation, clinical outcomes, and barriers to its implementation, and the context corresponds to pediatric intensive care units. This is a protocol for scoping review, conducted according to the JBI methodological recommendations (Peters et al., 2020) and reported according to the PRISMA-ScR checklist (Tricco et al., 2018), based on recognized methodological guidelines, involving a systematic search in health databases such as PubMed/MEDLINE, Embase, SciELO, LILACS, Scopus, Web of Science, and CINAHL, to select studies according to predefined criteria and perform a descriptive analysis of the evidence found. It is expected to identify differences in the indication criteria, ventilatory modes employed, interfaces used, and non-invasive ventilation adjustment parameters described in the included studies, as well as in the outcomes evaluated, such as mortality rate, intubation time, and length of stay in the intensive care unit. Furthermore, it is anticipated to identify factors associated with the success and failure of the intervention, as well as institutional and care barriers that hinder the standardization of clinical practice. In this way, the study will contribute to understanding the current scenario of non-invasive ventilation in pediatric intensive care, highlighting gaps in knowledge and the need for the development of structured, evidence-based protocols, with potential impact on the quality of care and clinical outcomes of this population.