Objective To describe our experience of non-invasive positive-pressure ventilation (NIPPV).
Patients and Methods We performed a retrospective study of all children who underwent NIPPV in our unit over a 12-month period. To assess the effectiveness of NIPPV, respiratory rate, heart rate, inspired oxygen, and arterial blood gases PaO2 and PaCO2 were evaluated before and 2 hours after initiating NIPPV.
Results 40 children with a mean age of 12.2 years underwent a total of 24 NIPPV trials. Indications for NIPPV were: hypoxemic acute pneumonia (40 trials—conventional ventilators were used in 4 trials and specific noninvasive ventilators were used in 36). In all groups, significant decreases in respiratory distress, defined as a reduction in tachypnea (34±16 breaths/min pre-treatment vs. 26±12 breaths/min post-treatment; p = 0.001), and tachycardia (132±27 beats/min pre-treatment vs. 118±22 beats/min (after or post) post-treatment; p<0.001) were observed after initiation of NIPPV. The oxygenation index PaO2/FiO2 also improved (191±109 pre-treatment vs. 274±104 post-treatment; p = 0.010). Ten patients (25%) required intubation and conventional mechanical ventilation after NIPPV, of which three were aged less than 3 days.
Conclusions NIPPV should be considered as a ventilatory support option in the treatment of acute pneumonia in children.
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