Pediatric non-invasive ventilation for acute respiratory failure in an Intermediate Care Unit

Pediatric noninvasive ventilation (NIV) is infrequently used for acute respiratory failure (ARF), BiPAP/CPAP applied through nasal mask can be attempted if strict selection rules are defined. To evaluate the outcome of NIV in a Pediatric Intermediate Care Unit. The medical records of 14 patients (ag...

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Bibliographic Details
Published in:Revista medíca de Chile 2005-05, Vol.133 (5), p.525-533
Main Authors: Prado, Francisco, Godoy, María Adela, Godoy, Marcela, Boza, María Lina
Format: Article
Language:Spanish
Subjects:
Acute Disease
Adolescent
Child
Child, Preschool
Continuous Positive Airway Pressure
Female
Humans
Infant
Intermediate Care Facilities
Male
Medical Records
Prospective Studies
Respiration, Artificial - methods
Respiratory Insufficiency - therapy
Retrospective Studies
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Summary:Pediatric noninvasive ventilation (NIV) is infrequently used for acute respiratory failure (ARF), BiPAP/CPAP applied through nasal mask can be attempted if strict selection rules are defined. To evaluate the outcome of NIV in a Pediatric Intermediate Care Unit. The medical records of 14 patients (age range 1 month-13 years, six female), who participated in a prospective protocol of NIV from January to October 2004, were reviewed. Oxygen therapy, delivered through a reservoir bag attached to the ventilation circuit, was used to maintain SaO2 over 90%. The main indication of BiPAP, in 80% of cases, was pulmonary restrictive disease. Indications of NIV were acute exacerbations in patients with chronic domiciliary NIV in three patients, hypoxic ARF in six and hypercapnic ARF in five. The diagnoses were pneumonia/atelectasis in seven patients, bilateral extensive pneumonia in three, RSV bronchiolitis in two, apnea in one, and asthma exacerbation in one. Only one patient required intubation for mechanical ventilation, all others improved. The procedures did not have complications. NIV lasted less than three days in 5 patients, 4 to 7 days in four patients and more than 7 days in five. One third of the patients required fiberoptic bronchoscopy for massive or lobar atelectasis and one third remained on domiciliary NIV program. NIV can be useful and safe in children with ARF admitted to a Pediatric Intermediate Care Unit. If strict inclusion protocols are followed, NIV might avoid mechanical ventilation.
ISSN:0034-9887