Non-Invasive Ventilation in Children with Paediatric Acute Respiratory Distress Syndrome

被引：3

作者：

Zeng, Jian Sheng ^{[1
]}

Qian, Su Yun ^{[1
]}

Wong, Judith J. M. ^{[2
]}

Ong, Jacqueline S. M. ^{[3
]}

Gan, Chin Seng ^{[4
]}

Anantasit, Nattachai ^{[5
]}

Chor, Yek Kee ^{[6
]}

Samransamruajkit, Rujipat ^{[7
]}

Phuc, Phan Huu ^{[8
]}

Phumeetham, Suwannee ^{[9
]}

Feng, Xu ^{[10
]}

Sultana, Rehena ^{[11
]}

Loh, Tsee Foong ^{[3
]}

Lee, Jan Hau ^{[3
]}

机构：

[1] Capital Med Univ, Beijing Childrens Hosp, Pediat Intens Care Unit, Beijing, Peoples R China

[2] KK Womens & Childrens Hosp, Dept Paediat Subspecialties, Childrens Intens Care Unit, Singapore, Singapore

[3] Natl Univ Singapore Hosp, Khoo Teck Puat Natl Univ Childrens Med Inst, Dept Paediat, Paediat Intens Care Unit, Singapore, Singapore

[4] Univ Malaya, Dept Paediat, Paediat Intens Care Unit, Kuala Lumpur, Malaysia

[5] Mahidol Univ, Dept Pediat, Div Pediat Crit Care, Bangkok, Thailand

[6] Sarawak Gen Hosp, Dept Paediat, Kuching, Malaysia

[7] King Chulalongkorn Mem Hosp, Dept Pediat, Div Pediat Crit Care, Bangkok, Thailand

[8] Natl Childrens Hosp, Pediat Intens Care Unit, Hanoi, Vietnam

[9] Mahidol Univ, Siriraj Hosp, Fac Med, Dept Pediat, Bangkok, Thailand

[10] Chongqing Med Univ, Childrens Hosp, Pediat Intens Care, Chongqing, Peoples R China

[11] Duke NUS Med Sch, Ctr Quantitat Med, Singapore, Singapore

来源：

ANNALS ACADEMY OF MEDICINE SINGAPORE | 2019年 / 48卷 / 07期

关键词：

Bi-level positive airway pressure; Continuous positive airway pressure; Non-invasive ventilation; ACUTE LUNG INJURY; FAILURE;

D O I：

暂无

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction: Evidence supporting non-invasive ventilation (NIV) in paediatric acute respiratory distress syndrome (PARDS) remains sparse. We aimed to describe characteristics of patients with PARDS supported with NIV and risk factors for NIV failure. Materials and Methods: This is a multicentre retrospective study. Only patients supported on NIV with PARDS were included. Data on epidemiology and clinical outcomes were collected. Primary outcome was NIV failure which was defined as escalation to invasive mechanical ventilation within the first 7 days of PARDS. Patients in the NIV success and failure groups were compared. Results: There were 303 patients with PARDS; 53/303 (17.5%) patients were supported with NIV. The median age was 50.7 (interquartile range: 15.7-111.9) months. The Paediatric Logistic Organ Dysfunction score and oxygen saturation/fraction of inspired oxygen (SF) ratio were 2.0 (1.0-10.0) and 155.0 (119.4-187.3), respectively. Indications for NIV use were increased work of breathing (26/53 [49.1%]) and hypoxia (22/53 [41.5%]). Overall NIV failure rate was 77.4% (41/53). All patients with sepsis who developed PARDS experienced NIV failure. NIV failure was associated with an increased median paediatric intensive care unit stay (15.0 [9.5-26.5] vs 4.5 [3.0-6.8] days; P<0.001) and hospital length of stay (26.0 [17.0-39.0] days vs 10.5 [5.5-22.3] days; P= 0.004). Overall mortality rate was 32.1% (17/53). Conclusion: The use of NIV in children with PARDS was associated with high failure rate. As such, future studies should examine the optimal selection criteria for NIV use in these children.

引用

页码：224 / 232

页数：9

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