{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T16:05:24Z","timestamp":1789920324553,"version":"4.0.1"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2003,5,1]],"date-time":"2003-05-01T00:00:00Z","timestamp":1051747200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,5,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Designing robust clinical trials in critically ill, mechanically ventilated children requires an understanding of the epidemiology and course of pediatric respiratory failure. As part of a clinical trial, we screened all mechanically ventilated children in nine large pediatric intensive care units (ICUs) across North America for 6 consecutive months. Of 6,403 total ICU admissions, 1,096 (17.1%) required mechanical ventilator support for a minimum of 24 hours. Of these, 701 (64%) met one or more exclusion criteria for trial enrollment. Common reasons for exclusion were upper airway obstruction (13.5%) and cyanotic congenital heart disease (11.5%). Life support interventions were restricted for 9.7% of patients, and 5.5% were chronically ventilator dependent. In the patients who were eligible for respiratory failure studies, 62.4% had an acute primary diagnosis of pulmonary disease, 14.2% neurologic disease, and 8.9% cardiac disease. Chronic underlying conditions were present in 43.2% of the patients. The most common acute diagnosis was bronchiolitis in infants (43.6%) and pneumonia in children 1 year old and older (24.5%). Mortality was rare (1.6%), and the median duration of ventilation was 7 days. The design of clinical trials in critically ill children is feasible but must account for the diverse population, infrequent mortality, and short duration of mechanical ventilation.<\/jats:p>","DOI":"10.1164\/rccm.200210-1175oc","type":"journal-article","created":{"date-parts":[[2003,5,8]],"date-time":"2003-05-08T13:54:20Z","timestamp":1052402060000},"page":"1334-1340","source":"Crossref","is-referenced-by-count":137,"title":["The Feasibility of Conducting Clinical Trials in Infants and Children with Acute Respiratory Failure"],"prefix":"10.1093","volume":"167","author":[{"given":"Adrienne G.","family":"Randolph","sequence":"first","affiliation":[{"name":"Department of Anesthesia, Children's Hospital; Departments of Anesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan; Department of Pediatrics, Children's Hospital Oakland, Oakland, California; Department of Pediatrics, Children's Medical Center of Dallas, Dallas, Texas; Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, Wisconsin; Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, Children's Hospital and Regional Medical Center, Seattle, Washington; Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Clinical Research Center, Children's Hospital, Boston, Massachusetts; and Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen L.","family":"Meert","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Children's Hospital; Departments of Anesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan; Department of Pediatrics, Children's Hospital Oakland, Oakland, California; Department of Pediatrics, Children's Medical Center of Dallas, Dallas, Texas; Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, Wisconsin; Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, Children's Hospital and Regional Medical Center, Seattle, Washington; Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Clinical Research Center, Children's Hospital, Boston, Massachusetts; and Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E.","family":"O'Neil","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Children's Hospital; Departments of Anesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan; Department of Pediatrics, Children's Hospital Oakland, Oakland, California; Department of Pediatrics, Children's Medical Center of Dallas, Dallas, Texas; Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, Wisconsin; Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, Children's Hospital and Regional Medical Center, Seattle, Washington; Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Clinical Research Center, Children's Hospital, Boston, Massachusetts; and Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James H.","family":"Hanson","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Children's Hospital; Departments of Anesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan; Department of Pediatrics, Children's Hospital Oakland, Oakland, California; Department of Pediatrics, Children's Medical Center of Dallas, Dallas, Texas; Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, Wisconsin; Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, Children's Hospital and Regional Medical Center, Seattle, Washington; Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Clinical Research Center, Children's Hospital, Boston, Massachusetts; and Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M.","family":"Luckett","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Children's Hospital; Departments of Anesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan; Department of Pediatrics, Children's Hospital Oakland, Oakland, California; Department of Pediatrics, Children's Medical Center of Dallas, Dallas, Texas; Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, Wisconsin; Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, Children's Hospital and Regional Medical Center, Seattle, Washington; Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Clinical Research Center, Children's Hospital, Boston, Massachusetts; and Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Children's Hospital; Departments of Anesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan; Department of Pediatrics, Children's Hospital Oakland, Oakland, California; Department of Pediatrics, Children's Medical Center of Dallas, Dallas, Texas; Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, Wisconsin; Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, Children's Hospital and Regional Medical Center, Seattle, Washington; Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Clinical Research Center, Children's Hospital, Boston, Massachusetts; and Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainer G.","family":"Gedeit","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Children's Hospital; Departments of Anesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan; Department of Pediatrics, Children's Hospital Oakland, Oakland, California; Department of Pediatrics, Children's Medical Center of Dallas, Dallas, Texas; Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, Wisconsin; Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, Children's Hospital and Regional Medical Center, Seattle, Washington; Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Clinical Research Center, Children's Hospital, Boston, Massachusetts; and Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter N.","family":"Cox","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Children's Hospital; Departments of Anesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan; Department of Pediatrics, Children's Hospital Oakland, Oakland, California; Department of Pediatrics, Children's Medical Center of Dallas, Dallas, Texas; Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, Wisconsin; Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, Children's Hospital and Regional Medical Center, Seattle, Washington; Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Clinical Research Center, Children's Hospital, Boston, Massachusetts; and Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan S.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Children's Hospital; Departments of Anesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan; Department of Pediatrics, Children's Hospital Oakland, Oakland, California; Department of Pediatrics, Children's Medical Center of Dallas, Dallas, Texas; Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, Wisconsin; Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, Children's Hospital and Regional Medical Center, Seattle, Washington; Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Clinical Research Center, Children's Hospital, Boston, Massachusetts; and Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shekhar T.","family":"Venkataraman","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Children's Hospital; Departments of Anesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan; Department of Pediatrics, Children's Hospital Oakland, Oakland, California; Department of Pediatrics, Children's Medical Center of Dallas, Dallas, Texas; Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, Wisconsin; Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, Children's Hospital and Regional Medical Center, Seattle, Washington; Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Clinical Research Center, Children's Hospital, Boston, Massachusetts; and Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter W.","family":"Forbes","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Children's Hospital; Departments of Anesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan; Department of Pediatrics, Children's Hospital Oakland, Oakland, California; Department of Pediatrics, Children's Medical Center of Dallas, Dallas, Texas; Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, Wisconsin; Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, Children's Hospital and Regional Medical Center, Seattle, Washington; Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Clinical Research Center, Children's Hospital, Boston, Massachusetts; and Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ira M.","family":"Cheifetz","sequence":"additional","affiliation":[{"name":"Department 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