title: Noninvasive ventilation in children: a review.
abstract: OBJECTIVE
  To assess the use of noninvasive ventilation (NIV) in children and its application in the acute and chronic setting of pediatric respiratory failure.
  
  
  METHODS
  Search of pertinent articles within PubMed, Cochrane and Ovid MEDLINE databases from 1950 to 2007, using the keywords pediatrics, noninvasive ventilation and positive airway pressure.
  
  
  RESULTS
  There is a paucity of published data on pediatric NIV. The majority of the data available are case reports or small case series, with a number of small, randomized studies reported.
  
  
  CONCLUSIONS
  Although the use of NIV is increasingly recognized in pediatrics, there are currently still no generally accepted guidelines for its use. In the chronic setting, its use has mainly been proven in obstructive sleep apnea and respiratory failure secondary to neuromuscular disorders. It would appear that the major challenge is ensuring compliance, and this can be enforced by patient/caregiver education, use of a suitable interface, heated humidifiers and by minimizing the side effects of NIV. In the setting of acute respiratory failure, it would appear from available data that success is usually predicted by the rapidity of response. Patients placed on NIV should be monitored closely and this mode of ventilation should be reviewed if there is a lack of response within a few hours after commencement of therapy.
authors.affiliation: Children's Intensive Care Unit, KK Women's and Children's Hospital, Singapore. Loh.Lik.Eng@kkh.com.sg
authors.forename: Lik Eng
authors.initials: LE
authors.lastname: Loh
authors.forename: Yoke Hwee
authors.initials: YH
authors.lastname: Chan
authors.forename: Irene
authors.initials: I
authors.lastname: Chan
mesh_terms: D000208:Acute Disease; D000402:Airway Obstruction; D001249:Asthma / Q000628:therapy; D002648:Child; D002908:Chronic Disease; D006801:Humans; D015278:Intensive Care Units, Pediatric; D011175:Positive-Pressure Respiration / Q000592:standards; D012131:Respiratory Insufficiency / Q000628:therapy*