title: [Noninvasive ventilation in a pediatric intensive care unit].
abstract: OBJECTIVE
  To describe our experience of noninvasive positive-pressure ventilation (NIPPV).
  
  
  METHODS
  We performed a retrospective study of all patients who underwent NIPPV in our unit over an 18-month period. To assess the effectiveness of NIPPV, respiratory rate, heart rate, inspired oxygen, and arterial blood gases PaO2 and PaCO2 were evaluated before and 2 hours after initiating NIPPV.
  
  
  RESULTS
  Twenty-three patients with a mean age of 36.7 months underwent a total of 24 NIPPV trials. Indications for NIPPV were: hypoxemic acute respiratory failure (14 trials), hypercapnic acute respiratory failure (four trials), and postextubation respiratory failure (six trials). Conventional ventilators were used in 10 trials and specific noninvasive ventilators were used in 14. The main interfaces used were buconasal mask in patients older than 1 year, and pharyngeal prong in infants aged less than 1 year. In all groups, significant decreases in respiratory distress, defined as a reduction in tachypnea (45 +/- 16 breaths/min pre-treatment vs. 34 +/- 12 breaths/min post-treatment; p = 0.001), and tachycardia (148 +/- 27 beats/min pre-treatment vs. 122 +/- 22 beats/min (after or post) post-treatment; p < 0.001) were observed after initiation of NIPPV. The oxygenation index PaO2/FiO2 also improved (190 +/- 109 pre-treatment vs. 260 +/- 118 post-treatment; p = 0.010). Five patients (20.8 %) required intubation and conventional mechanical ventilation after NIPPV, of which three were aged less than 6 months.
  
  
  CONCLUSIONS
  NIPPV should be considered as a ventilatory support option in the treatment of acute respiratory failure in selected children.
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Universidad de Oviedo, Spain. jmedina@hcas.sespa.es
authors.forename: A
authors.initials: A
authors.lastname: Medina Villanueva
authors.forename: S
authors.initials: S
authors.lastname: Prieto Espuñes
authors.forename: M
authors.initials: M
authors.lastname: Los Arcos Solas
authors.forename: C
authors.initials: C
authors.lastname: Rey Galán
authors.forename: A
authors.initials: A
authors.lastname: Concha Torre
authors.forename: S
authors.initials: S
authors.lastname: Menéndez Cuervo
authors.forename: M
authors.initials: M
authors.lastname: Crespo Hernández
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D008297:Male; D012121:Respiration, Artificial; D012189:Retrospective Studies