Article Text

NON-INVASIVE VENTILATION – A LEICESTER (UK) EXPERIENCE TO EVALUATE ITS ROLE AS A WEANING MODE OF VENTILATION FROM PICU
  1. A L Mukherjee1,
  2. A Sapare1,
  3. S Nichani1
  1. 1PICU, Leicester Royal Infirmary, Leicester, UK

Abstract

Introduction The portable non-invasive positive pressure ventilator (NIPPV) is widely used in High Dependency Units (HDU). This retrospective case notes review aimed to look at the use of NIPPV ventilators for supporting children with respiratory failure and transferring from paediatric Intensive Care Unit (PICU) to HDU (between January 2005 and August 2007).

Results In the twelve children (age range 0.1 to 16 years, M: F 7: 5), NIPPV was used primarily to wean from conventional ventilation in the intensive care.

11 children (91.66%) were ventilated via tracheostomy and 1 (8.4%) via facemask.

After initiation of the NIPPV:

  • 4 showed improvement in the gas exchange (decline in paCO2 by 1 kilopascal);

  • 4 showed initial temporary deterioration;

  • 4 stayed the same.

The ventilation was weaned by either increasing time off or changing to CPAP mode. The duration of support varied from 2 days to more than 2 months, with 2 children continuing for more than a year. Five out of ten children (83.33%) discharged into the community remained on home ventilation. One child died due to chronic lung disease and another from a brain tumour.

Conclusion We conclude that the portable NIPPV ventilator can be a very useful method of weaning the respiratory support in children with complex needs from PICU level to HDU. Significant numbers of PICU bed days were saved by transferring these patients to HDU. We will need formal prospective randomised controlled trials to establish these findings.

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