title: Non-invasive mechanical ventilation after heart surgery in children.
abstract: The purpose of the study was to analyze the characteristics and evolution of non-invasive mechanical ventilation (NIV) in the postoperative period of heart surgery in children.
  
  
  
  Retrospective observational study including all children requiring NIV after heart surgery in a single center pediatric intensive care unit (PICU) between 2001 and 2012. Demographic characteristics, ventilation parameters and outcomes were registered, comparing the first 6 years of the study with the last 6 years.
  
  
  
  935 children required invasive or non-invasive mechanical ventilation, of which 200 (21.4) received NIV. The median duration of NIV was 3 days. Mortality rate was 3.9%. The use of NIV increased from 13.2% in the first period to 29.2% in the second period (p <0.001). Continuous positive airway pressure (CPAP) was the most common modality of NIV (65.5%). The use of bilevel positive airway pressure mode (BIPAP) increased from 15% in the first period to 42.9% in the second period (p < 0.001). The nasopharyngeal tube was the most common interface (66%), but the use of nasal cannula increased from 3.3 to 41.4% in the second period (p < 0.001). NIV failed in 15% of patients. The mortality rate did not change, the duration of NIV decreased and the PICU length of stay increased throughout the study.
  
  
  
  NIV is increasingly being used in the postoperative period of heart surgery in our center with an 85% success rate and is associated with a lesser need for invasive mechanical ventilation. CPAP was the most common modality and the "nasopharyngeal tube" was the most common interface in our study although, in the latter years, the use of BIPAP and nasal cannula has increased significantly.
authors.affiliation: Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón, Calle Dr. Castelo 47, 28009, Madrid, Spain. sarahlafever@gmail.com.|Gregorio Marañon University Hospital Biomedical Research Foundation, Research Network on Maternal and Child Health and Development II (Red SAMID II), Madrid, Spain. sarahlafever@gmail.com.
authors.forename: Sarah
authors.initials: S
authors.lastname: Fernández Lafever
authors.affiliation: Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón, Calle Dr. Castelo 47, 28009, Madrid, Spain.|Gregorio Marañon University Hospital Biomedical Research Foundation, Research Network on Maternal and Child Health and Development II (Red SAMID II), Madrid, Spain.
authors.forename: Blanca
authors.initials: B
authors.lastname: Toledo
authors.affiliation: Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón, Calle Dr. Castelo 47, 28009, Madrid, Spain.|Gregorio Marañon University Hospital Biomedical Research Foundation, Research Network on Maternal and Child Health and Development II (Red SAMID II), Madrid, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Leiva
authors.affiliation: Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón, Calle Dr. Castelo 47, 28009, Madrid, Spain.|Gregorio Marañon University Hospital Biomedical Research Foundation, Research Network on Maternal and Child Health and Development II (Red SAMID II), Madrid, Spain.
authors.forename: Maite
authors.initials: M
authors.lastname: Padrón
authors.affiliation: Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón, Calle Dr. Castelo 47, 28009, Madrid, Spain.|Gregorio Marañon University Hospital Biomedical Research Foundation, Research Network on Maternal and Child Health and Development II (Red SAMID II), Madrid, Spain.
authors.forename: Marina
authors.initials: M
authors.lastname: Balseiro
authors.affiliation: Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón, Calle Dr. Castelo 47, 28009, Madrid, Spain.|Gregorio Marañon University Hospital Biomedical Research Foundation, Research Network on Maternal and Child Health and Development II (Red SAMID II), Madrid, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Carrillo
authors.affiliation: Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón, Calle Dr. Castelo 47, 28009, Madrid, Spain. pielvi@hotmail.com.|Gregorio Marañon University Hospital Biomedical Research Foundation, Research Network on Maternal and Child Health and Development II (Red SAMID II), Madrid, Spain. pielvi@hotmail.com.|Department of Pediatrics, School of Medicine, Complutense University of Madrid, Madrid, Spain. pielvi@hotmail.com.
authors.forename: Jesús
authors.initials: J
authors.lastname: López-Herce
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D002675:Child, Preschool; D045422:Continuous Positive Airway Pressure / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000458:organization & administration; D007902:Length of Stay; D008297:Male; D063087:Noninvasive Ventilation / Q000639:trends*; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D012131:Respiratory Insufficiency / Q000453:epidemiology; D012189:Retrospective Studies; D013030:Spain
keywords: Children; Heart surgery; Non-invasive ventilation