title: Esogastric pressure measurement to assist noninvasive ventilation indication and settings in infants with hypercapnic respiratory failure: A pilot study.
abstract: Noninvasive ventilation (NIV) in usually set on clinical parameters. The aim of the study was to assess the value of esophageal (PES) and gastric pressure (PGAS) measurements for the indication and optimal settings of NIV in infants with hypercapnic respiratory failure in whom the efficacy of NIV was uncertain on clinical noninvasive parameters.
  
  
  
  A retrospective study.
  
  
  
  PESand PGASmeasurements were performed in seven infants <2 years old admitted in the Pediatric Intensive Care Unit for an acute or acute-on-chronic hypercapnic respiratory failure.
  
  
  
  PESswing and esophageal pressure time product (PTPES) during spontaneous breathing, NIV set on clinical parameters (NIVclin) and on PES(NIVphys) were compared. According to the PESmeasurements, NIV was continued if NIV was associated with an at least 20% reduction of the PESswing and PTPESand not initiated or withdrawn in the other case.
  
  
  
  In all seven patients, the PESand PGASmeasurements were informative and led to the decision to initiate NIV in one patient or continue NIV with different settings in three patients. In the three other patients, NIV was not initiated in one patient and withdrawn in the two last patients because of a lack of improvement in PESswing and PTPES.
  
  
  
  PESand PGASmeasurements may be useful for the indication and optimal setting of NIV in a selected group of infants with hypercapnic respiratory failure.
authors.affiliation: AP-HP, Hôpital Necker, Pediatric Intensive Care Unit, Paris, France.|INSERM U 955, Equipe 13, 8 rue du Général Sarrail, Créteil, France.|Université de Montréal, Bld Edouard Montpetit, Montréal, Canada.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Mortamet
authors.affiliation: ASV Santé, Gennevilliers, France.|AP-HP, Hôpital Necker, Pediatric Noninvasive Ventilation and Sleep Unit, Paris, France.
authors.forename: Sonia
authors.initials: S
authors.lastname: Khirani
authors.affiliation: INSERM U 955, Equipe 13, 8 rue du Général Sarrail, Créteil, France.|AP-HP, Hôpital Necker, Pediatric Noninvasive Ventilation and Sleep Unit, Paris, France.|Université de Paris Descartes, Paris, France.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Amaddeo
authors.affiliation: Université de Montréal, Bld Edouard Montpetit, Montréal, Canada.|CHU Sainte-Justine Pediatric Intensive Care Unit, CHU Sainte-Justine, Montreal, Canada.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Emeriaud
authors.affiliation: AP-HP, Hôpital Necker, Pediatric Intensive Care Unit, Paris, France.|Université de Paris Descartes, Paris, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Renolleau
authors.affiliation: INSERM U 955, Equipe 13, 8 rue du Général Sarrail, Créteil, France.|AP-HP, Hôpital Necker, Pediatric Noninvasive Ventilation and Sleep Unit, Paris, France.|Université de Paris Descartes, Paris, France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Fauroux
mesh_terms: D004947:Esophagus / Q000502:physiology*; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000503:physiopathology / Q000628:therapy*; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D063087:Noninvasive Ventilation; D010865:Pilot Projects; D011312:Pressure; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000503:physiopathology / Q000628:therapy*; D013270:Stomach / Q000502:physiology*
keywords: esogastric pressure; infants; noninvasive ventilation; respiratory failure