NON INVASIVE VENTILATION IN A PEDIATRIC INTENSIVE CARE UNIT

NON INVASIVE VENTILATION IN A PEDIATRIC INTENSIVE CARE UNIT Background: Non-invasive ventilation (NIV) is being increasingly used in children with acute respiratory failure, preventing complications associated with conventional mechanical ventilation. Aims: To determinate the efficacy of NIV in children with acute respiratory failure or chronic respiratory failure. Methods: Prospective study of all patients who underwent NIV (November 2005 to April 2008). Demographic data and the following parameters were analysed: Heart and respiratory rate, SaO(2), blood gases evaluated before and at 1, 2, 6, 12, and 24 hours after NIV. Results: One hundred and thirteen were included (116 NIV trials). Mean age 9,4 +/- 26,2 months (median: 1,5 months). CPAP used in 63 and BiPAP in 53 trials. Diagnosis: bronchiolitis in 61 (52,6%), pneumonia in 36 (31,0%) patients. Indications for NIV: acute hypercapnic and/or hypoxemic respiratory failure in 109 (94%), apnoea (13), chronic pulmonary disease agudization (three), partial obstruction of upper airway (four). There was a significant improvement in respiratory and heart rates, pH, pCO2 at 1, 2, 4, 6, 12, 24 and 48 hours after NIV onset (p < 0,05) (table). Mean duration of NIV was 47,7 +/- 35,6 hours. Sedation with chloral hydrate was used in 58 (50%). Twenty eight patients (24,1%), required conventional mechanical ventilation (main reason: apnea+bradicardia: 8). There were no major complications related with NIV. Conclusions: NIV can be effective in children and infants with acute respiratory failure, preventing some patients from deteriorating and/or from being ventilated.