title: Non-invasive ventilation as primary ventilatory support for infants with severe bronchiolitis.
abstract: OBJECTIVE
  To report our experience of non-invasive ventilation (NIV) as primary ventilatory support strategy in infants admitted for severe bronchiolitis.
  
  
  METHODS
  Retrospective study in a paediatric intensive care unit of an university hospital.
  
  
  METHODS
  Infants aged less than 12 months, admitted for bronchiolitis during 2003-2004 and 2004-2005 winter epidemics.
  
  
  METHODS
  NIV was used as the primary ventilatory support during the second winter (NIV period), whereas invasive ventilation (IV) was the only support employed during the first winter (IV period). NIV consisted in either continuous positive airway pressure (CPAP from 5 to 10 cmH(2)O) or bilevel positive airway pressure (inspiratory pressure from 12 to 18 cmH(2)O) with a nasal mask.
  
  
  RESULTS
  During the IV period, 53 infants were included, compared to 27 during the NIV period. The two groups did not differ in age or in number of premature births. Children in NIV group had less apnoea on admission. The intubation rate was reduced during NIV period (p < 0.001). No children had ventilator-associated pneumonia (VAP) during NIV period compared to nine during IV period (p < 0.05). In the NIV group, 10 infants (37%) required supplemental oxygen for more than 8 days compared to 33 children (65%) in IV group (p < 0.05). The length of hospital stay and the duration of ventilation were similar.
  
  
  CONCLUSIONS
  In this retrospective study, the use of NIV decreased the rate of ventilator associated pneumonia and reduced the duration of oxygen requirement without prolonging the hospital stay.
authors.affiliation: Service de Réanimation Pédiatrique Hôpital Femme Mère Enfant, Groupement Hospitalier Est, 59 Boulevard Pinel, Hospices Civils de Lyon, Université Lyon 1, 69677, Bron Cedex, France. etienne.javouhey@chu-lyon.fr
authors.forename: Etienne
authors.initials: E
authors.lastname: Javouhey
authors.forename: Audrey
authors.initials: A
authors.lastname: Barats
authors.forename: Nathalie
authors.initials: N
authors.lastname: Richard
authors.forename: Didier
authors.initials: D
authors.lastname: Stamm
authors.forename: Daniel
authors.initials: D
authors.lastname: Floret
mesh_terms: D001988:Bronchiolitis / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay; D008297:Male; D053717:Pneumonia, Ventilator-Associated; D011175:Positive-Pressure Respiration / Q000706:statistics & numerical data*; D012189:Retrospective Studies