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Research Snapshot Theater: Pulmonary, Adult and Pediatric

Evaluating Mechanical Ventilation Practices for Adolescents and Young Adults in Respiratory Failure

Monday, March 23, 2026
11:30 AM - 12:30 PM Central Time
Location: Connections Central - RST 09

  • Kevin Gochenour, MD, FAAP (he/him/his)

    University of Michigan, Michigan

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • MN

    Mark Nuppnau, n/a

    Senior Analyst
    University of Michigan Hospital and Health Systems, Michigan

    Disclosure information not submitted.

  • AB

    Anna Barker, MD

    Clinical Instructor
    University of Michigan Hospital and Health Systems, Michigan

    Disclosure information not submitted.

  • MS

    Michale Sjoding, MD, MSc

    Associate Professor
    University of Michigan Hospital and Health Systems, Michigan

    Disclosure information not submitted.

  • Ryan Barbaro, MD, MS

    University of Michigan Health System

    Disclosure information not submitted.

  • HF

    Heidi Flori, MD, FAAP

    Clinical Professor
    University of Michigan Hospital and Health Systems, Michigan

    Disclosure information not submitted.

  • JK

    Joseph Kohne, MD

    Clinical Associate Professor of Pediatrics
    University of Michigan CS Mott Children's Hospital, Michigan

    Disclosure information not submitted.

Introduction: Adolescents and young adults (AYA) are underrepresented in acute respiratory failure (RF) research, making it unclear if their findings generalize to AYA. Research focused on AYA is needed due to their disproportionate years of life at risk from RF. AYAs are cared for in both pediatric (PICU) or adult (MICU) intensive care units (ICUs), therefore future research requires an understanding of real-world care. We hypothesize that invasive mechanical ventilation (IMV) practices for AYA with RF differ between PICUs and MICUs.


Methods: We performed a retrospective cohort study of AYA patients (18–25 years) with RF requiring IMV, admitted to PICUs and MICUs at a single center (Jan 2016–Dec 2024). Patients with tracheostomy, P/F ratio >300, or admitted to pediatric cardiothoracic ICU were excluded. Variables are reported as n (%) or median (IQR). We compared tidal volume per kg ideal body weight (VT/kg IBW), PEEP, and FiO2 during the first 24 hours of IMV by ICU type, adjusting for age, SOFA score, IBW, and P/F ratio using linear regression. We report unadjusted comparisons of 30-day mortality, ventilator-free days, and ICU length of stay.


Results: Of 678 included patients, 172 (25%) were admitted to the PICU. Median age was 19 (18–20) years in PICU and 23 (21–24) years in MICU (p < 0.001). PICU AYA had a lower IBW (57 [50–68] vs. 66 [55–75] kg; p= < 0.001) and higher Elixhauser comorbidity score (19 [9–31] vs. 14 [4–26]; p< 0.001) than MICU AYA. P/F ratio was 191 (114-238) in PICU and 171 (102–228) in MICU (p=0.066); about half in both groups had a P/F ratio < 200 . PICU AYA received higher VT/kg IBW (6.9 [5.5–7.7] vs. 6.6 [6.0–7.4]; p=0.044) and PEEP (7.9 [6.0–10.7] vs. 5.9 [5.0-8.9]; p=0.005) than MICU AYA. Mortality was higher in PICU (31 [18%] vs. 77 [15%]; p=0.39). PICU survivors had more ventilator-free days (5 [3-12] vs. 4 [2-8]; p=0.001) but longer ICU length of stay (11 [4-25] vs. 7 [3-15]; p=0.012).


Conclusions: IMV strategies for AYA differ by ICU type, with observed variation potentially impacting outcomes. Future AYA-focused research across ICUs should consider pragmatic care and support the development of consensus IMV guidelines for AYA with respiratory failure.