Predicting non-invasive ventilation failure in children from the SpO2/FiO2 (SF) ratio

Mayordomo-Colunga, Juan; Pons, Martí; Lopez, Yolanda; Solana, María José; Rey, Corsino; Martínez–Camblor, Pablo; Rodrı́guez-Núñez, Antonio; López‐Herce, Jesús; Medina, Alberto; Abadesso, Clara; Teresa, María; Gáboli, Mirella; García-López, Mireia; González-Sánchez, M.R.; Madurga-Revilla, P.; González-Calvar, Amelia; Oñate, Eider

doi:10.1007/s00134-013-2880-5

Cited by 79 publications

(73 citation statements)

References 31 publications

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“…The S/F ratio (peripheral oxygen saturation/ inspired oxygen fraction) is a useful tool to monitor NRS treatment and outcome, but it had not yet been validated at the time of the trial. 36 …”

Section: Discussionmentioning

confidence: 99%

Continuous Positive Airway Pressure With Helmet Versus Mask in Infants With Bronchiolitis: An RCT

et al. 2015

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BACKGROUND: Noninvasive continuous positive airway pressure (CPAP) is usually applied with a nasal or facial mask to treat mild acute respiratory failure (ARF) in infants. A pediatric helmet has now been introduced in clinical practice to deliver CPAP. This study compared treatment failure rates during CPAP delivered by helmet or facial mask in infants with respiratory syncytial virus-induced ARF. METHODS:In this multicenter randomized controlled trial, 30 infants with respiratory syncytial virus-induced ARF were randomized to receive CPAP by helmet (n = 17) or facial mask (n = 13). The primary endpoint was treatment failure rate (defined as due to intolerance or need for intubation). Secondary outcomes were CPAP application time, number of patients requiring sedation, and complications with each interface.RESULTS: Compared with the facial mask, CPAP by helmet had a lower treatment failure rate due to intolerance (3/17 [17%] vs 7/13 [54%], P = .009), and fewer infants required sedation (6/17 [35%] vs 13/13 [100%], P = .023); the intubation rates were similar. In successfully treated patients, CPAP resulted in better gas exchange and breathing pattern with both interfaces. No major complications due to the interfaces occurred, but CPAP by mask had higher rates of cutaneous sores and leaks.CONCLUSIONS: These findings confirm that CPAP delivered by helmet is better tolerated than CPAP delivered by facial mask and requires less sedation. In addition, it is safe to use and free from adverse events, even in a prolonged clinical setting. WHAT'S KNOWN ON THIS SUBJECT:In a previous short-term physiologic randomized controlled trial, continuous positive airway pressure by helmet was feasible and efficient in improving gas exchange in pediatric acute respiratory failure due to bronchiolitis. WHAT THIS STUDY ADDS:Continuous positive airway pressure administered by helmet reduces the rate of noninvasive respiratory support failure and provides longer application time with less sedation than a facial mask. In addition, it is safe to use and free from adverse events.

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Section: Discussionmentioning

confidence: 99%

Continuous Positive Airway Pressure With Helmet Versus Mask in Infants With Bronchiolitis: An RCT

et al. 2015

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“…Mayordomo-Colunga [65] reported an 81 % success rate for 369 patients receiving NIV in a prospective multicenter cohort study. This fell to 50 % in the subgroup with ARDS.…”

Section: Respiratory and Mechanical Ventilationmentioning

confidence: 99%

Year in review in Intensive Care Medicine 2013: III. Sepsis, infections, respiratory diseases, pediatrics

et al. 2014

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“…In the general PICU population, several predictors of NIV failure – the need for subsequent intubation – have been identified: second organ failure , the need for a high level of support (mean pressure >12 cm H 2 O or FiO 2 > 0.6) , the severity of the illness, as reflected by a high paediatric logistic organ dysfunction score or high paediatric risk of mortality score , or the presence of acute respiratory distress syndrome . Other predictive criteria emphasise the importance of the first hours of treatment when considering the likelihood of NIV failure: a pH of <7.25 after two hours of treatment , a SpO 2 /FiO 2 ratio <193 after one hour of NIV , an FiO 2 > 80% after one hour of NIV or the absence of reduction in the respiratory rate after 2 or 6 hours of treatment have been associated with subsequent intubation.…”

Section: Success and Failurementioning

confidence: 99%

Non-invasive ventilation is useful in paediatric intensive care units if children are appropriately selected and carefully monitored

et al. 2015

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Predicting non-invasive ventilation failure in children from the SpO2/FiO2 (SF) ratio

Abstract: SF ratio is a reliable predictor of early NIV failure in children.

Cited by 79 publications

References 31 publications

Continuous Positive Airway Pressure With Helmet Versus Mask in Infants With Bronchiolitis: An RCT

Continuous Positive Airway Pressure With Helmet Versus Mask in Infants With Bronchiolitis: An RCT

Year in review in Intensive Care Medicine 2013: III. Sepsis, infections, respiratory diseases, pediatrics

Non-invasive ventilation is useful in paediatric intensive care units if children are appropriately selected and carefully monitored

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