[Pediatric non-invasive ventilation for acute respiratory failure in an Intermediate Care Unit].
BACKGROUND
Pediatric noninvasive ventilation (NIV) is infrequently used for acute respiratory failure (ARF), BiPAP/CPAP applied through nasal mask can be attempted if strict selection rules are defined.


OBJECTIVE
To evaluate the outcome of NIV in a Pediatric Intermediate Care Unit.


METHODS
The medical records of 14 patients (age range 1 month-13 years, six female), who participated in a prospective protocol of NIV from January to October 2004, were reviewed. Oxygen therapy, delivered through a reservoir bag attached to the ventilation circuit, was used to maintain SaO2 over 90%.


RESULTS
The main indication of BiPAP, in 80% of cases, was pulmonary restrictive disease. Indications of NIV were acute exacerbations in patients with chronic domiciliary NIV in three patients, hypoxic ARF in six and hypercapnic ARF in five. The diagnoses were pneumonia/atelectasis in seven patients, bilateral extensive pneumonia in three, RSV bronchiolitis in two, apnea in one, and asthma exacerbation in one. Only one patient required intubation for mechanical ventilation, all others improved. The procedures did not have complications. NIV lasted less than three days in 5 patients, 4 to 7 days in four patients and more than 7 days in five. One third of the patients required fiberoptic bronchoscopy for massive or lobar atelectasis and one third remained on domiciliary NIV program.


CONCLUSIONS
NIV can be useful and safe in children with ARF admitted to a Pediatric Intermediate Care Unit. If strict inclusion protocols are followed, NIV might avoid mechanical ventilation.
Prado
Francisco
F
Departamento de Pediatría, Campus Centro, Facultad de Medicina, Universidad de Chile, Santiago, Chile. panchoprado2004@yahoo.com
Godoy
María Adela
MA
Godoy
Marcela
M
Boza
María Lina
ML
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D007223:Infant; D007380:Intermediate Care Facilities; D008297:Male; D008499:Medical Records; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods*; D012131:Respiratory Insufficiency / Q000628:therapy*; D012189:Retrospective Studies