Cardiopulmonary interactions during paediatric mechanical ventilation: protocol for a scoping review

Introduction

The heart and lungs are closely linked anatomically and physiologically, sharing the thoracic cavity and jointly ensuring oxygenation and removal of carbon dioxide. With the introduction of positive pressure ventilation, significant changes in cardiopulmonary dynamics were noted. Guyton described these mechanisms of reduced venous return and cardiac output via elevated right atrial pressure. Mechanical ventilation, particularly positive pressure ventilation, is widely used in paediatric critical care, yet data on its clinical effects on children’s circulation remain limited. Many principles deduced from experiments on animals and adult physiology are applied to critically ill children. This scoping review will aim to summarise current evidence on the effect of mechanical ventilation on the circulation in critically ill children and to identify knowledge gaps to address in future research.

Methods and analysis

The scoping review will follow the Joanna Briggs Institute (JBI) protocol for scoping reviews. PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science Core Collection will be searched as well as clinical trial registries ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. Studies will be included if they describe a cardiovascular outcome after changing any ventilatory parameter or mode. The search is scheduled for the first of June 2026, and we plan to finish the paper before 31 December 2026.

All search results will be uploaded to EndNote where duplicate records will be identified and removed. Titles/abstracts will be screened by two independent reviewers based on inclusion criteria using the online software of Rayyan. Full texts of potentially relevant sources will be screened by two independent reviewers. Reasons for exclusions will be documented and disagreements resolved through discussion or a third reviewer. Data will be extracted by at least two reviewers using a tool developed by the team based on the JBI guidance. Describing and/or plotting of the results will be an iterative process, but adjustments will be clarified and tested against the PRISMA Extension for Scoping Reviews.

Ethics and dissemination

Ethical approval from the Institutional Review Board is not required for this study since all investigations are being carried out on previously published manuscripts. There will be no involvement of new patients or other study participants of any kind. The review will be registered and the protocol published in order to maintain methodological transparency. Final results will be compiled and submitted for publication once the study has been completed and all data has been charted/analysed.