N Observations 1,415 (100%) / High PaO2
(>68 mmHg)
1,099 (77.7%) / Mid PaO2
(55-68 mmHg)
244 (17.2%) / Low PaO2
(<55 mmHg)
72 (5.1%)
PaO2 Median (IQR) / 103 (83,135) / 62 (59,65) / 50 (45,52)
FiO2 Changes
Clinician FiO2 = Protocol FiO2 / 363 (33%) / 79 (32.4%) / 34 (47.2%)
Clinician FiO2 < Protocol FiO2 / 247 (22.5%) / 79 (32.4%) / 14 (19.4%)
Clinician FiO2 > Protocol FiO2 / 489 (44.5%) / 86 (35.2%) / 24 (33.4%)
PEEP Changes
Clinician PEEP = Protocol PEEP / 600 (54.6%) / 107 (43.9%) / 22 (30.6%)
Clinician PEEP < Protocol PEEP / 55 (5%) / 86 (35.2%) / 41 (56.9%)
Clinician PEEP > Protocol PEEP / 444 (40.4%) / 51 (20.9%) / 9 (12.5%)
Non co-morbid Cohort
N Observations 1,484 (100%) / High PaO2
(>68 mmHg)
1,188 (80%) / Mid PaO2
(55-68 mmHg)
215 (14.5%) / Low PaO2
(<55 mmHg)
81 (5.5%)
PaO2 Median (IQR) / 103 (83,133) / 62 (59,65) / 48 (41,51)
FiO2 Changes
Clinician FiO2 = Protocol FiO2 / 396 (33.3%) / 77 (35.8%) / 49 (60.5%)
Clinician FiO2 < Protocol FiO2 / 241 (20.3%) / 57 (26.5%) / 13 (16%)
Clinician FiO2 > Protocol FiO2 / 551 (46.4%) / 81 (37.7%) / 19 (23.5%)
PEEP Changes
Clinician PEEP = Protocol PEEP / 640 (53.9%) / 93 (43.2%) / 19 (23.4%)
Clinician PEEP < Protocol PEEP / 54 (4.5%) / 73 (34%) / 51 (63%)
Clinician PEEP > Protocol PEEP / 494 (41.6%) / 49 (22.8%) / 11 (13.6%)
Table ESM 1 (a top, b bottom):The top table (a) includes only observations from patients with chest-x ray findings of bilateral infiltrates (ALI Cohort). The bottom table (b) includes only observations from patients who are free from co-morbid conditions which may affect mechanical ventilator management (non co-morbid Cohort). Clinical care changes to FiO2 and PEEP which clinicians made in response to an arterial blood gas (Clinician) compared to the changes that would have been recommended by the pediatric mechanical ventilation protocol (Protocol). Changes to FiO2 and PEEP are grouped by PaO2. Data are reported as the number and percentage of observations within each PaO2 range in which clinician choices for FiO2 and PEEP were less than, in line, or greater than the protocol’s recommendations.