Physiological effects of noninvasive positive ventilation during acute moderate hypercapnic respiratory insufficiency in children

Introduction A prospective physiological study was performed in 12 paediatric patients with acute moderate hypercapnic respiratory insufficiency to assess the ability of noninvasive positive pressure ventilation (NPPV) to unload the respiratory muscles and improve gas exchange. Materials and methods...

Full description

Saved in:
Bibliographic Details
Published in:Intensive care medicine 2008-12, Vol.34 (12), p.2248-2255
Main Authors: Essouri, Sandrine, Durand, Philippe, Chevret, Laurent, Haas, Vincent, Perot, Claire, Clement, Annick, Devictor, Denis, Fauroux, Brigitte
Format: Article
Language:English
Subjects:
Adolescent
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anesthesiology
Biological and medical sciences
Blood Gas Analysis
Child
Child, Preschool
Continuous Positive Airway Pressure
Critical Care Medicine
Emergency and intensive respiratory care
Emergency Medicine
Female
Humans
Intensive
Intensive care medicine
Intensive Care Units
Male
Medical sciences
Medicine
Medicine & Public Health
Pain Medicine
Pediatric Original
Pediatrics
Pneumology/Respiratory System
Positive-Pressure Respiration
Respiration
Respiratory Insufficiency - therapy
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Introduction A prospective physiological study was performed in 12 paediatric patients with acute moderate hypercapnic respiratory insufficiency to assess the ability of noninvasive positive pressure ventilation (NPPV) to unload the respiratory muscles and improve gas exchange. Materials and methods Breathing pattern, gas exchange, and inspiratory muscle effort were measured during spontaneous breathing and NPPV. Results NPPV was associated with a significant improvement in breathing pattern, gas exchange and respiratory muscle output. Tidal volume and minute ventilation increased by 33 and 17%, and oesophageal and diaphragmatic pressure time product decreased by 49 and 56%, respectively. This improvement in alveolar ventilation translated into a reduction in mean partial pressure in carbon dioxide from 48 to 40 mmHg ( P  = 0.01) and in respiratory rate from 48 to 41 breaths/min ( P  = 0.01). No difference between a clinical setting and a physiological setting of NPPV was observed. In conclusion, this study shows that NPPV is able to unload the respiratory muscles and improve clinical outcome in young patients admitted to the paediatric intensive care unit for acute moderate hypercapnic respiratory insufficiency.
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-008-1202-9