ENVIRONMENTAL-FACTORS INFLUENCING WEANING OF A YOUNG-CHILD FROM MECHANICAL VENTILATOR SUPPORT

We examined the contribution of physiologic and environmental variable s to the process of weaning a child with chronic respiratory failure f rom mechanical ventilation support. Surveillance measures, e.g., blood oxygenation, were obtained from a 6-year-old child with multiple medi cal and developmental disorders who received three different rates (24 , 22, and 20 tidal volumes per minute) of intermittent mechanical vent ilation. Direct observations were used to calculate rates of aberrant behavior, e.g., aggression toward self, for task versus play settings within the intermittent mechanical ventilation rates. Rates of aberran t behavior and adult responses were tabulated from videotaped observat ions for task, attention, and no attention settings. The greatest rate of aberrant behavior occurred during tasks compared with play activit ies, regardless of whether attention was provided while playing. Adult s also responded more often to aberrant behaviors during task versus p lay conditions. Clinical implications are discussed concerning the inc lusion of developmental and behavioral variables during weaning from m echanical ventilation.