title: [Non-invasive ventilation in children: Do we need more evidence?]
abstract: Respiratory failure is the leading cause of hospital admissions in the pediatric intensive care unit (PICU) and is associated with significant morbidity and mortality. Mechanical ventilation, preferentially delivered by a non-invasive route (NIV), is currently the first-line treatment for respiratory failure since it is associated with a reduction in the intubation rate. This ventilatory support is increasingly used in the PICU, but its wider use contrasts with the paucity of studies in this field. This review aims to describe the main indications of NIV in acute settings: (i) bronchiolitis; (ii) postextubation respiratory failure; (iii) acute respiratory distress syndrome; (iv) pneumonia; (v) status asthmaticus; (vi) acute chest syndrome; (vii) left heart failure; (viii) exacerbation of chronic respiratory failure; (ix) upper airway obstruction and (x) end-of-life care. Most of these data are based on descriptive studies and expert opinions, and few are from randomized trials. While the benefit of NIV is significant in some indications, such as bronchiolitis, it is more questionable in others. Monitoring these patients for the occurrence of NIV failure markers is crucial.
authors.affiliation: Unité de soins intensifs pédiatriques, CHU Sainte-Justine, 3175 côte Sainte-Catherine, QC H3T 1C4 Montréal, Canada; Université de Montréal, 2900, boulevard Édouard-Monpetit, QC H3T 1J4 Montréal, Canada; Unité Inserm U955, équipe 13, institut de recherche biomédicale Mondor, 8, rue du Général-Sarrail, 94000 Créteil, France. Electronic address: mortam@hotmail.fr.
authors.forename: G
authors.initials: G
authors.lastname: Mortamet
authors.affiliation: Unité de soins intensifs pédiatriques, CHU Sainte-Justine, 3175 côte Sainte-Catherine, QC H3T 1C4 Montréal, Canada; Université de Montréal, 2900, boulevard Édouard-Monpetit, QC H3T 1J4 Montréal, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Emeriaud
authors.affiliation: Unité de soins intensifs pédiatriques, CHU Sainte-Justine, 3175 côte Sainte-Catherine, QC H3T 1C4 Montréal, Canada; Université de Montréal, 2900, boulevard Édouard-Monpetit, QC H3T 1J4 Montréal, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Jouvet
authors.affiliation: Unité Inserm U955, équipe 13, institut de recherche biomédicale Mondor, 8, rue du Général-Sarrail, 94000 Créteil, France; Unité de ventilation non invasive et du sommeil de l'enfant, hôpital Necker, Assistance publique-Hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Fauroux
authors.affiliation: Université de Montréal, 2900, boulevard Édouard-Monpetit, QC H3T 1J4 Montréal, Canada; Département de pédiatrie, CHU Sainte-Justine, 3175 côte Sainte-Catherine, QC H3T 1C4 Montréal, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Essouri
mesh_terms: D056586:Acute Chest Syndrome / Q000628:therapy; D060666:Airway Extubation / Q000009:adverse effects; D000402:Airway Obstruction / Q000628:therapy; D001249:Asthma / Q000628:therapy; D001988:Bronchiolitis / Q000628:therapy; D002648:Child; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D063087:Noninvasive Ventilation; D010166:Palliative Care; D011014:Pneumonia / Q000628:therapy; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy