Ventilation non invasive des nourrissons ayant une infection respiratoire sévère présumée à virus respiratoire syncitial : faisabilité et critères d'échec

Campion, A.; Huvenne, H.; Leteurtre, Stéphane; Noizet, O.; Binoche, A.; Diependaele, J.-F.; Cremer, R.; Fourier, C.; Ardıç, Sadık; Leclerc, F.

doi:10.1016/j.arcped.2006.08.003

Cited by 53 publications

(18 citation statements)

References 18 publications

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“…NPPV can be an attractive alternative to IMV for these patients. Clinical trials in children with acute lower respiratory airway obstruction have suggested that NPPV may improve symptoms and ventilation without significant adverse events and reduce the need for IMV [10-20]. NPPV theoretically improves the respiratory status of patients with lower respiratory airway obstruction by several mechanisms [37].…”

Section: Nppv In Pediatric Arf From Primary Respiratory Diseasementioning

confidence: 99%

Noninvasive positive pressure ventilation for acute respiratory failure in children: a concise review

Najaf-Zadeh

Leclerc

2011

Ann. Intensive Care

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Noninvasive positive pressure ventilation (NPPV) refers to the delivery of mechanical respiratory support without the use of endotracheal intubation (ETI). The present review focused on the effectiveness of NPPV in children > 1 month of age with acute respiratory failure (ARF) due to different conditions. ARF is the most common cause of cardiac arrest in children. Therefore, prompt recognition and treatment of pediatric patients with pending respiratory failure can be lifesaving. Mechanical respiratory support is a critical intervention in many cases of ARF. In recent years, NPPV has been proposed as a valuable alternative to invasive mechanical ventilation (IMV) in this acute setting. Recent physiological studies have demonstrated beneficial effects of NPPV in children with ARF. Several pediatric clinical studies, the majority of which were noncontrolled or case series and of small size, have suggested the effectiveness of NPPV in the treatment of ARF due to acute airway (upper or lower) obstruction or certain primary parenchymal lung disease, and in specific circumstances, such as postoperative or postextubation ARF, immunocompromised patients with ARF, or as a means to facilitate extubation. NPPV was well tolerated with rare major complications and was associated with improved gas exchange, decreased work of breathing, and ETI avoidance in 22-100% of patients. High FiO2 needs or high PaCO2 level on admission or within the first hours after starting NPPV appeared to be the best independent predictive factors for the NPPV failure in children with ARF. However, many important issues, such as the identification of the patient, the right time for NPPV application, and the appropriate setting, are still lacking. Further randomized, controlled trials that address these issues in children with ARF are recommended.

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Section: Nppv In Pediatric Arf From Primary Respiratory Diseasementioning

confidence: 99%

Noninvasive positive pressure ventilation for acute respiratory failure in children: a concise review

Najaf-Zadeh

Leclerc

2011

Ann. Intensive Care

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“…[13] and Campion et al . [14] reported a success of 83% in children with bronchiolitis managed with CPAP. A success rate of 81% was observed in the study by Javouhey et al .,[15] and 75.5% by Larrar et al .…”

Section: Discussionmentioning

confidence: 99%

“…[78] Infants were observed to have a higher rate of CPAP failure which was supported by many other studies. [1113141718]…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of flow inflating device in providing Continuous Positive Airway Pressure for critically ill children in limited-resource settings: A prospective observational study

Anitha¹,

Velmurugan

Sangareddi

et al. 2016

Indian Journal of Critical Care Medicine

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Background and Aims:Noninvasive ventilation (NIV) is an emerging popular concept, which includes bi-level positive airway pressure or continuous positive airway pressure (CPAP). In settings with scarce resources for NIV machines, CPAP can be provided through various indigenous means and one such mode is flow inflating device - Jackson-Rees circuit (JR)/Bain circuit. The study analyses the epidemiology, various clinical indications, predictors of CPAP failure, and stresses the usefulness of flow inflating device as an indigenous way of providing CPAP.Methods:A prospective observational study was undertaken in the critical care unit of a Government Tertiary Care Hospital, from November 2013 to September 2014. All children who required CPAP in the age group 1 month to 12 years of both sexes were included in this study. They were started on indigenous CPAP through flow inflating device on clinical grounds based on the pediatric assessment triangle, and the duration and outcome were analyzed.Results:This study population included 214 children. CPAP through flow inflating device was successful in 89.7% of cases, of which bronchiolitis accounted for 98.3%. A prolonged duration of CPAP support of >96 h was required in pneumonia. CPAP failure was noted in 10.3% of cases, the major risk factors being children <1 year and pneumonia with septic shock.Conclusion:We conclude that flow inflating devices - JR/Bain circuit are effective as an indigenous CPAP in limited resource settings. Despite its benefits, CPAP is not a substitute for invasive ventilation, as when the need for intubation arises timely intervention is needed.

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“…In the published studies, the infants with bronchiolitis were referred to an intensive care unit (ICU) [11,14-18] or high dependency unit [19] when treated with CPAP. Treatment in an ICU is resource demanding and may be frightening for the parents.…”

Section: Introductionmentioning

confidence: 99%

Continuous positive airway pressure for bronchiolitis in a general paediatric ward; a feasibility study

Øymar

Bårdsen

2014

BMC Pediatr

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BackgroundContinuous positive airway pressure (CPAP) is commonly used to relieve respiratory distress in infants with bronchiolitis, but has mostly been studied in an intensive care setting. Our prime aim was to evaluate the feasibility of CPAP for infants with bronchiolitis in a general paediatric ward, and secondary to assess capillary PCO2 (cPCO2) levels before and during treatment.MethodsFrom May 1st 2008 to April 30th 2012, infants with bronchiolitis at Stavanger University Hospital were treated with CPAP in a general paediatric ward, but could be referred to an intensive care unit (ICU) when needed, according to in-house guidelines. Levels of cPCO2 were prospectively registered before the start of CPAP and at approximately 4, 12, 24 and 48 hours of treatment as long as CPAP was given. We had a continuous updating program for the nurses and physicians caring for the infants with CPAP. The study was population based.Results672 infants (3.4%) were hospitalized with bronchiolitis. CPAP was initiated in 53 infants (0.3%; 7.9% of infants with bronchiolitis), and was well tolerated in all but three infants. 46 infants were included in the study, the majority of these (n = 33) were treated in the general ward only. These infants had lower cPCO2 before treatment (8.0; 7.7, 8.6)(median; quartiles) than those treated at the ICU (n = 13) (9.3;8.5, 9.9) (p < 0.001). The level of cPCO2 was significantly reduced after 4 h in both groups; 1.1 kPa (paediatric ward) (p < 0.001) and 1.3 kPa (ICU) (p = 0.002). Two infants on the ICU did not respond to CPAP (increasing cPCO2 and severe apnoe) and were given mechanical ventilation, otherwise no side effects were observed in either group treated with CPAP.ConclusionTreatment with CPAP for infants with bronchiolitis may be feasible in a general paediatric ward, providing sufficient staffing and training, and the possibility of referral to an ICU when needed.

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Ventilation non invasive des nourrissons ayant une infection respiratoire sévère présumée à virus respiratoire syncitial : faisabilité et critères d'échec

Cited by 53 publications

References 18 publications

Noninvasive positive pressure ventilation for acute respiratory failure in children: a concise review

Noninvasive positive pressure ventilation for acute respiratory failure in children: a concise review

Effectiveness of flow inflating device in providing Continuous Positive Airway Pressure for critically ill children in limited-resource settings: A prospective observational study

Continuous positive airway pressure for bronchiolitis in a general paediatric ward; a feasibility study

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