[Respiratory failure in cystic fibrosis: management in pediatric intensive care unit, lung transplantation recommendation].
Admission to the ICU for respiratory failure of a child with cystic fibrosis is a telltale sign of the severity of the disease. Bronchopulmonary exacerbation, pneumothorax and hemoptysis are the primary causes, for which respiratory assistance is indispensable in these life-threatening situations. Non-invasive ventilation (NIV) has enabled significant progress in improving patient survival. The modalities of NIV must be tailored to both the patient and the cause of respiratory failure. Invasive ventilation, on the other hand, should be a treatment of last resort, because often associated with high mortality. It must be adapted to the therapeutic strategy involving an impending transplantation, including in critical situations where placement on a high emergency list is a possibility. Since admission to ICU is at times the reflection of the terminal evolution of the disease, ongoing treatment must hence be adapted to the comfort of the child.
Service de réanimation pédiatrique et néonatale, Hôpital des Enfants, 330 avenue de Grande-Bretagne, 31026 Toulouse cedex 3, France. pelluau.s@chu-toulouse.fr
S
S
Pelluau
M
M
Oualha
R
R
Souilamas
P H
PH
Hubert
D002648:Child; D003550:Cystic Fibrosis / Q000150:complications*; D006801:Humans; D007362:Intensive Care Units; D016040:Lung Transplantation; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000601:surgery*