[Non-invasive ventilation in infants with severe infection presumably due to respiratory syncytial virus: feasibility and failure criteria].
Beneficial effect of continuous positive airway pressure (CPAP) during non invasive ventilation (NIV) has been reported in infants with respiratory syncytial virus (RSV) infection, but no study has analyzed the predictors of its failure.


OBJECTIVE
To evaluate the feasibility of NIV and to determine NIV failure criteria.


METHODS
All infants hospitalized in one PICU with presumed RSV infection between 2002 and 2006 were prospectively included. When respiratory support was needed, NIV was first started according to a pre-established protocol.


RESULTS
One hundred and one infants, 43 females, 58 males, median age 49 days (range: 10-334), median weight 3.9 kg (range: 2,4-12) were included. RSV infection was confirmed in 84/101. Sixty-seven infants were transported by the paediatric medical transport system, 27 with NIV and 15 with invasive ventilation (IV). Fifteen infants were in IV at admission, 69 received NIV during their PICU stay (12 secondarily requiring IV) and 17 were never ventilated. A significant decrease in PCO2 with increase in pH was observed within 2 hours of NIV. Parameters associated with NIV failure were apneas, high values of admission PCO2 and H24 PRISM score. The 17 non-ventilated infants were older and had a lower severity score than those who were ventilated.


CONCLUSIONS
In infants with RSV and needing respiratory support, NIV represented the sole method of respiratory support in 68% of cases. NIV failure criteria were apneas, high values of admission PCO2 and H24 PRISM score.
Campion
A
A
Service de réanimation pédiatrique, hôpital Jeanne-de-Flandre, 59037 Lille cedex, France.
Huvenne
H
H
Leteurtre
S
S
Noizet
O
O
Binoche
A
A
Diependaele
J-F
JF
Cremer
R
R
Fourier
C
C
Sadik
A
A
Leclerc
F
F
D002648:Child; D002675:Child, Preschool; D045422:Continuous Positive Airway Pressure; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D018357:Respiratory Syncytial Virus Infections / Q000628:therapy*; D012720:Severity of Illness Index; D017211:Treatment Failure