title: A novel technique of non-invasive ventilation: Pharyngeal oxygen with nose-closure and abdominal-compression--Aid for pediatric flexible bronchoscopy.
abstract: OBJECTIVE
  To evaluate the safety, feasibility and efficacy of a novel non-invasive ventilation (NIV) technique--pharyngeal oxygen with nose-closure and abdominal-compression (PhO2 -NC-AC)--to aid pediatric flexible bronchoscopy (FB).
  
  
  METHODS
  A prospective 1 year study of patients who received FB. A basic PhO2 flow (0.5-1.0 L/kg/min, maximal 5.0 L/min) was routinely applied. Active NIV was initiated when the heart rate dropped <80 beats/min or desaturation was <80% for >10 sec. It was performed as follows: NC 1 sec for inspiration then released, followed by AC 1 sec for active expiration at a rate of 20-30 cycles/min until vital signs returned to acceptable levels for >10 sec. When the patients were stable, supplementary NIV was optionally given. Cardiopulmonary parameters were collected and analyzed.
  
  
  RESULTS
  Three hundred thirty-seven FBs, including 188 therapeutic, were conducted in 286 patients with a mean age of 18.3 months (± 14.4, 10 min to 12 years) and a mean body weight of 13.5 kg (± 6.7, 0.5-35 kg). Three hundred thirty-three active NIVs were executed with a mean duration of 87.8 sec (± 40.4, 28-190 sec). A significantly longer FB duration (33.2 ± 16.7 min vs. 7.2 ± 2.8 min, P < 0.001) and a higher application rate of active NIV (1.44/FB vs. 0.42/FB) were noted in the therapeutic compared to the diagnostic group. Vital signs and blood gases (35 cases) improved rapidly and returned to baseline within 3 min. All FBs were safely and successfully completed without significant complications.
  
  
  CONCLUSIONS
  PhO2 -NC-AC is a simple, safe and effective NIV technique for respiratory support and rescue during various pediatric FB procedures.
authors.affiliation: Children's Medical Center, Taipei Veterans General Hospital, Taiwan, Republic of China.|Institute of Emergency and Critical Care Medicines, School of Medicine, National Yang-Ming University, Taiwan, Republic of China.
authors.forename: Wen-Jue
authors.initials: WJ
authors.lastname: Soong
authors.affiliation: Children's Medical Center, Taipei Veterans General Hospital, Taiwan, Republic of China.|Institute of Emergency and Critical Care Medicines, School of Medicine, National Yang-Ming University, Taiwan, Republic of China.
authors.forename: Mei-Jy
authors.initials: MJ
authors.lastname: Jeng
authors.affiliation: Children's Medical Center, Taipei Veterans General Hospital, Taiwan, Republic of China.
authors.forename: Yu-Sheng
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Children's Medical Center, Taipei Veterans General Hospital, Taiwan, Republic of China.|Institute of Emergency and Critical Care Medicines, School of Medicine, National Yang-Ming University, Taiwan, Republic of China.
authors.forename: Pei-Chen
authors.initials: PC
authors.lastname: Tsao
authors.affiliation: Children's Medical Center, Taipei Veterans General Hospital, Taiwan, Republic of China.
authors.forename: Morgan
authors.initials: M
authors.lastname: Harloff
authors.affiliation: Department of Medicine, Los Angeles County + USC Medical Center, Los Angeles, California.
authors.forename: Yen-Hui
authors.initials: YH
authors.lastname: Matthew Soong
mesh_terms: D000293:Adolescent; D001999:Bronchoscopy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D063087:Noninvasive Ventilation / Q000379:methods*; D009666:Nose; D010100:Oxygen; D010614:Pharynx; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D010100:Oxygen
keywords: abdominal compression; non-invasive ventilation; nose-closure ventilation; positive pressure ventilation; resuscitation; therapeutic flexible bronchoscopy