Article Text

PEDIATRIC NON-INVASIVE VENTILATION: A PROSPECTIVE DESCRIPTIVE STUDY
  1. J Mayordomo-Colunga1,
  2. C Rey2,
  3. A Medina1,
  4. A Concha1,
  5. M Arcos1,
  6. S Menéndez1
  1. 1Department of Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
  2. 2Universidad de Oviedo, Oviedo, Asturias, Spain

Abstract

Objective Determination of non-invasive ventilation (NIV) characteristics in pediatric patients.

Methods Prospective observational study performed in a Pediatric Intensive Care Unit (PICU) in a University Hospital. Eighty-seven patients were included. Clinical and epidemiological data were collected. Conditions precipitating respiratory failure were classified into two groups: type 1 ARF (hypoxemic) − 29 episodes; and type 2 ARF (hypercapnic) − 58 episodes.

Results Fifty-three patients were males (60.9%). Median age was 9.1 months (0.5–169.1), and median weight was 8.4 kg (2.8–40). Most common admission diagnoses were pneumonia (89.7%) in type 1 ARF and bronchiolitis (41.4%) and asthma (36.3%) in type 2 ARF. Respiratory rate decreased from 53.5±18.3 before NIV began to 36.4±9.1 at 6 hours (p<0.001), while heart rate decreased from 163.1±29.7 to 135.6±23.5 (p<0.001) and FiO2 from 0.44±0.24 to 0.39±0.16 (p = 0.092). Face masks were used in 61 episodes and nasal masks in 25. NIV median duration was 39 hours (range: 2–375). Sedatives were administered in 63.2% (continuous perfusion in 50.6%), and enteral nutrition was given in 48.2% of the children. Complications secondary to NIV were detected in 21 episodes (24.1%): non-severe skin lesion in 17, pneumothorax in 3, and upper airways bleeding in 1. Four children died, but none of deaths was related to NIV use. NIV success rate was 86.2% (72.4% in type 1 ARF and 93.1% in type 2 ARF).

Conclusions NIV is a safe and useful respiratory support technique in pediatric patients, even in small toddlers. Sedative use is frequent.

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