Feasibility of non-invasive pressure support ventilation in infants with respiratory failure after extubation: a pilot study.
OBJECTIVE
To evaluate the feasibility and effects of non-invasive pressure support ventilation (NIV) on the breathing pattern in infants developing respiratory failure after extubation.


METHODS
Prospective pilot clinical study; each patient served as their own control.


METHODS
A nine-bed paediatric intensive care unit of a tertiary university hospital.


METHODS
Six patients (median age 5 months, range 0.5-7 months; median weight 4.2 kg, range 3.8-5.1 kg) who developed respiratory failure after extubation.


METHODS
After a period of spontaneous breathing (SB), children who developed respiratory failure were treated with NIV.


RESULTS
Measurements included clinical dyspnoea score (DS), blood gases and oesophageal pressure recordings, which were analysed for respiratory rate (RR), oesophageal inspiratory pressure swing (dPes) and oesophageal pressure-time product (PTPes). All data were collected during both periods (SB and NIV). When comparing NIV with SB, DS was reduced by 44% (P < 0.001), RR by 32% (P < 0.001), dPes by 45% (P < 0.01) and PTPes by 57% (P < 0.001). A non-significant trend for decrease in PaCO(2) was observed.


CONCLUSIONS
In these infants, non-invasive pressure support ventilation with turbine flow generator induced a reduction of breathing frequency, dPes and PTPes, indicating reduced load of the inspiratory muscles. NIV can be used with some benefits in infants with respiratory failure after extubation.
Stucki
Pascal
P
Pediatric Intensive Care Unit, Centre Hospitalier Universitaire Vaudois, CHUV BH-05, 1011 Lausanne, Switzerland. dr.p.stucki@bluewin.ch
Perez
Marie-Hélène
MH
Scalfaro
Pietro
P
de Halleux
Quentin
Q
Vermeulen
François
F
Cotting
Jacques
J
D045422:Continuous Positive Airway Pressure; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000628:therapy*