Objective This study was performed to determine faisability and efficacy of Noninvasive postive pressure ventilation (NPPV) for infant and children with acute respiratory failure (ARF).
Materials and Methods During March 2006 to December 2011, we include in this prospective observational study infants and children ≤ 16 years of age hospitalized at the multidisciplinary PICU of the university teaching hospital of Oran with hypoxemic or hypercarbic acute respiratory distress. The patients were eligible to receive in first intention mask ventilation by means of a conventional volumetric ventilators as an alternative means of respiratory support in association with conventional medical treatment. Patients were evaluated regarding physiologic variables prospectively before NIV and at 2 hrs of NPPV.
Results A total of 109 patients were included. The average of age been of 57.07±57.95 months, we use NPPV for 22 (20%) children with hypercarbic acute respiratory failure (ARF), for 87 (80%) with hypoxemic ARF. 44 (40%) patients had ARF after extubation. The BiPAP mode was used among all patients. After the second hour of NPPV we observe reduction of respiratory rate (43.72±13.46 b/min vs 34.25±13.47, p<0.01), heart rate (138.66 b/min vs 129.27±24.21, p<0.01) and improvement of the SPO2 (86.17±13.33 vs 94.85±6.9, p<0.01). We listed only 36 (33%) failures which had recourse to the intubation.
Conclusion The NPPV is an interesting technique in PICU and the results are promising. The post-extubation ARF is probably a better indication for NPPV in paediatrics.