Comparison Between Noninvasive Mechanical Ventilation and Standard Oxygen Therapy in Children Up to 3 Years Old With Respiratory Failure After Extubation

Fioretto, José Roberto; Ribeiro, Cristiane Franco; Carpi, Mário Ferreira; Bonatto, Rossano César; Moraes, Marcela Aparecida de; Fioretto, Eduardo; Fagundes, Djalma José

doi:10.1097/pcc.0000000000000309

Cited by 37 publications

(47 citation statements)

References 41 publications

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“…Previous single-center studies demonstrate the safety and effectiveness of NIV in the management of respiratory insufficiency in infants and children [1-3], including those undergoing cardiac surgery [4-8]. NIV therapy may hold promise to decrease ICU length of stay, complications associated with invasive respiratory support, and improve other clinical outcomes for patients in the CICU by allowing reduction in mechanical ventilation (MV).…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Noninvasive Ventilation in Pediatric Cardiac ICUs*

Romans

Schwartz

Costello

et al. 2017

Pediatric Critical Care Medicine

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Objective To describe the epidemiology of noninvasive ventilation (NIV) therapy for patients admitted to pediatric cardiac intensive care units (CICU), and to assess practice variation across hospitals. Design Retrospective cohort study using prospectively collected clinical registry data. Setting Pediatric Cardiac Critical Care Consortium (PC4) clinical registry. Patients Patients admitted to CICUs at PC4 hospitals. Interventions None. Measurements and Main Results We analyzed all CICU encounters that included any respiratory support from 10/2013-12/2015. NIV therapy included high flow nasal cannula (HFNC) and positive airway pressure (PAP) support. We compared patient and, when relevant, perioperative characteristics of those receiving NIV to all others. Subgroup analysis was performed on neonates and infants undergoing major cardiovascular surgery. To examine duration of respiratory support we created a casemix-adjustment model and calculated adjusted mean durations of total respiratory support (MV + NIV), MV, and NIV. We compared adjusted duration of support across hospitals. The cohort included 8,940 encounters from 15 hospitals: 3,950 (44%) received NIV, 72% were neonates and infants. Medical encounters were more likely to include NIV than surgical. In surgical neonates and infants, 2,032 (55%) received postoperative NIV. Neonates, extracardiac anomalies, single ventricle, procedure complexity, preoperative respiratory support, MV duration, and postoperative disease severity were associated with NIV therapy (p<0.001 for all). Across hospitals, NIV use ranged from 32%-65%, and adjusted mean NIV duration ranged from 1-4 days (3 days observed mean). Duration of total adjusted respiratory support was more strongly correlated with duration of MV compared to NIV (Pearson's r=0.93 vs 0.71, respectively). Conclusions NIV use is common in CICUs, especially in patients admitted for medical conditions, infants, and those undergoing high complexity surgery. We observed wide variation in NIV use across hospitals, though the primary driver of total respiratory support time seems to be duration of MV.

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Section: Introductionmentioning

confidence: 99%

Epidemiology of Noninvasive Ventilation in Pediatric Cardiac ICUs*

Romans

Schwartz

Costello

et al. 2017

Pediatric Critical Care Medicine

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“…While Tume et al reported a 52% use ‘to avoid intubation, Fanning et al found 81% of participants reporting a willingness to use NIV in high‐risk extubation failure. Fioretto et al did not find any significant difference between NIV (delivered by means of a face or nasal mask and a conventional ventilator) and standard oxygen therapy after extubation. Further research on this topic is warranted.…”

Section: Discussionmentioning

confidence: 94%

“…There is scarce information about the use and effectiveness of NIV after extubation in children. The use of NIV immediately after endotracheal tube removal (as part of the weaning process), has been proven to be useful in some adult patients, while this has not been shown in children to date . On the other hand, NIV has not shown to be effective when ARF ensues after extubation in adult patients …”

Section: Introductionmentioning

confidence: 99%

Non‐invasive ventilation practices in children across Europe

Mayordomo-Colunga

Pons-Òdena²,

Medina

et al. 2018

Pediatric Pulmonology

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“…The role for NIV in children developing acute respiratory failure (ARF) after extubation has been recently evaluated in a RCT [21] comparing NPPV and standard oxygen therapy for preventing reintubation in children. One hundred eight children undergoing invasive ventilation for at least 48 h with respiratory failure after programmed extubation were prospectively enrolled and randomly assigned into NPPV group and inhaled oxygen group.…”

Section: Noninvasive Ventilation In Pediatric Icumentioning

confidence: 99%

Mechanical ventilation for children

Conti

Piastra²

2016

Current Opinion in Critical Care

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Despite the improvement observed in the last decades in the treatment of pediatric acute respiratory failure and the diffusion of innovative modes of mechanical ventilation, there are no clear and consistent guidelines for the use of mechanical ventilation for children. In several areas data are still lacking, and in many others they are extrapolated from studies performed in adults; the direct evaluation of results obtained from studies specific to the pediatric population is therefore crucial.

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Comparison Between Noninvasive Mechanical Ventilation and Standard Oxygen Therapy in Children Up to 3 Years Old With Respiratory Failure After Extubation

Cited by 37 publications

References 41 publications

Epidemiology of Noninvasive Ventilation in Pediatric Cardiac ICUs*

Epidemiology of Noninvasive Ventilation in Pediatric Cardiac ICUs*

Non‐invasive ventilation practices in children across Europe

Mechanical ventilation for children

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