Noninvasive ventilation in a pediatric ICU: factors associated with failure

Objective Evaluate the efficacy of Noninvasive Mechanical Ventilation (NIV) in preventing Endotracheal Intubation (ETI) in a heterogeneous pediatric population and identify predictive factors associated with NIV failure in Pediatric Intensive Care Unit (PICU). Methods Prospective non-randomized clin...

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Bibliographic Details
Published in:Jornal brasileiro de pneumologia 2020, Vol.46 (6), p.e20180053-e20180053
Main Authors: Grande, Rosângela Aparecida Alves, Fernandes, Gabriela Albuquerque, Andrade, Daniela Pascoal, Matsunaga, Natasha Yumi, Oliveira, Therezinha de, Almeida, Celize Cruz Bresciani, Cohen, Milena Antonelli
Format: Article
Language:English
Subjects:
Child
Child, Preschool
Humans
Infant
Infant, Newborn
Intensive Care Units, Pediatric - statistics & numerical data
Male
Noninvasive Ventilation - methods
Prospective Studies
Respiration, Artificial - methods
Respiration, Artificial - statistics & numerical data
Respiratory Insufficiency - diagnosis
Respiratory Insufficiency - therapy
Treatment Outcome
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Summary:Objective Evaluate the efficacy of Noninvasive Mechanical Ventilation (NIV) in preventing Endotracheal Intubation (ETI) in a heterogeneous pediatric population and identify predictive factors associated with NIV failure in Pediatric Intensive Care Unit (PICU). Methods Prospective non-randomized clinical trial conducted with patients aged 0-10 years, hospitalized in a PICU with NIV indication, who presented acute or chronic respiratory failure. Demographic data and clinical and cardiorespiratory parameters were evaluated, and patients who did not progress to ETI in 48 h after withdrawal of NIV were classified as "success group", whereas those who progressed to ETI were included in the "failure group". Multivariate logistic regression was performed to identify the predictive factors of failure to prevent ETI. Results Fifty-two patients, 27 (51.9%) males, with median age of 6 (1-120) months were included in the study. When evaluating the effectiveness of NIV, 36 (69.2%) patients were successful, with no need for ETI. After analyzing the predictive factors associated with failure, patients with tachypnea after 2 h of NIV were 4.8 times more likely to require ETI in 48 h. Regardless of outcome, heart (p
ISSN:1806-3756
1806-3756
DOI:10.36416/1806-3756/e20180053