title: Is a nasopharyngeal tube effective as interface to provide bi-level noninvasive ventilation?
abstract: BACKGROUND
  The nasopharyngeal tube (NT) is a potential interface for noninvasive ventilation (NIV) available in all health care centers. The aim of the study was to describe our experience in the use of the NT for bi-level NIV in infants and its effectiveness.
  
  
  METHODS
  Prospective observational study from January 2007 to December 2010, including all patients ≤ 6 months old admitted to the pediatric ICU (PICU) and treated with NIV with two levels of pressure using the NT. Clinical data collected before starting NIV, and at 2, 8, 12 and 24 h, were analyzed following NIV initiation: first-line or initial NIV (i-NIV), elective postextubation NIV (e-NIV), and rescue postextubation NIV (r-NIV). The need for intubation was considered to be NIV failure.
  
  
  RESULTS
  One hundred fifty-one episodes of NIV were included in the study, with 65% of patients having bronchiolitis. e-NIV was most frequently used (48%) (i-NIV 44%, r-NIV 8%), and the failure rate, 27% in total, was highest in the i-NIV group (37%) (e-NIV 18%, r-NIV 25%). Case patients with successful outcomes had shorter PICU stays (8.5 vs. 13 d, P = .001) and hospital stays (17 vs. 23 d, P = .03) stays. The NT needed to be changed for another interface in only 5 case patients, few complications (4 of 151 patients) were observed, and mortality (2 of 151 patients) was unrelated to NIV.
  
  
  CONCLUSIONS
  Use of the NT showed 73% effectiveness, with few complications. The effectiveness was higher in e-NIV than i-NIV.
authors: Pediatric Intensive Care Unit, Hospital Universitario Sant Joan de Déu, Barcelona, Spain.
authors: Eneritz
authors: E
authors: Velasco Arnaiz
authors: Francisco José
authors: FJ
authors: Cambra Lasaosa
authors: Lluïsa
authors: L
authors: Hernández Platero
authors: Núria
authors: N
authors: Millán García Del Real
authors: Martí
authors: M
authors: Pons-Òdena
mesh_terms: D060666:Airway Extubation; D001988:Bronchiolitis / Q000628:therapy; D013504:Cardiovascular Surgical Procedures; D006339:Heart Rate; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D007320:Inspiratory Capacity; D015278:Intensive Care Units, Pediatric; D007440:Intubation / Q000295:instrumentation*; D007902:Length of Stay / Q000706:statistics & numerical data; D063087:Noninvasive Ventilation / Q000295:instrumentation* / Q000379:methods*; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000628:therapy
chemical_list: D006993:Hypnotics and Sedatives
keywords: airway extubation; bronchiolitis; infant; noninvasive ventilation; pediatric intensive care units; respiratory insufficiency