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01.09.2009 | Pediatric Brief Report

Feasibility of non-invasive pressure support ventilation in infants with respiratory failure after extubation: a pilot study

verfasst von: Pascal Stucki, Marie-Hélène Perez, Pietro Scalfaro, Quentin de Halleux, François Vermeulen, Jacques Cotting

Erschienen in: Intensive Care Medicine | Ausgabe 9/2009

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Abstract

Objective

To evaluate the feasibility and effects of non-invasive pressure support ventilation (NIV) on the breathing pattern in infants developing respiratory failure after extubation.

Design

Prospective pilot clinical study; each patient served as their own control.

Setting

A nine-bed paediatric intensive care unit of a tertiary university hospital.

Patients

Six patients (median age 5 months, range 0.5–7 months; median weight 4.2 kg, range 3.8–5.1 kg) who developed respiratory failure after extubation.

Interventions

After a period of spontaneous breathing (SB), children who developed respiratory failure were treated with NIV.

Measurements and results

Measurements included clinical dyspnoea score (DS), blood gases and oesophageal pressure recordings, which were analysed for respiratory rate (RR), oesophageal inspiratory pressure swing (dPes) and oesophageal pressure-time product (PTPes). All data were collected during both periods (SB and NIV). When comparing NIV with SB, DS was reduced by 44% (P < 0.001), RR by 32% (P < 0.001), dPes by 45% (P < 0.01) and PTPes by 57% (P < 0.001). A non-significant trend for decrease in PaCO₂ was observed.

Conclusion

In these infants, non-invasive pressure support ventilation with turbine flow generator induced a reduction of breathing frequency, dPes and PTPes, indicating reduced load of the inspiratory muscles. NIV can be used with some benefits in infants with respiratory failure after extubation.

Yañez LJ, Yunge M, Emilfork M, Lapadula M, Alcántara A, Fernández C, Lozano J, Contreras M, Conto L, Arevalo C, Gayan A, Hernández F, Pedraza M, Feddersen M, Bejares M, Morales M, Mallea F, Glasinovic M, Cavada G (2008) A prospective, randomized, controlled trial of noninvasive ventilation in pediatric acute respiratory failure. Pediatr Crit Care Med 9:484–489PubMedCrossRef

Essouri S, Nicot F, Clément A, Garabedian EN, Roger G, Lofaso F, Fauroux B (2005) Noninvasive positive pressure ventilation in infants with upper airway obstruction: comparison of continuous and bilevel positive pressure. Intensive Care Med 31:574–580PubMedCrossRef

Cambonie G, Milesi C, Jaber S, Amsallem F, Barbotte E, Picaud JC, Matecki S (2008) Nasal continuous positive airway pressure decreases respiratory muscles overload in young infants with severe acute viral bronchiolitis. Intensive Care Med 34:1865–1872PubMedCrossRef

Chin K, Takahashi K, Ohmori K, Toru I, Matsumoto H, Niimi A, Doi H, Ikeda T, Nakahata T, Komeda M, Mishima M (2007) Noninvasive ventilation for pediatric patients under 1 year of age after cardiac surgery. J Thorac Cardiovasc Surg 134:260–261PubMedCrossRef

Essouri S, Durand P, Chevret L, Haas V, Perot C, Clement A, Devictor D, Fauroux B (2008) Physiological effects of noninvasive positive ventilation during acute moderate hypercapnic respiratory insufficiency in children. Intensive Care Med 34:2248–2255PubMedCrossRef

Gopinath SP, Robertson CS, Contant CF, Narayan RK, Grossman RG (1995) Clinical evaluation of a miniature strain-gauge transducer for monitoring intracranial pressure. Neurosurgery 36:1137–1141PubMedCrossRef

Coates A, Stocks J, Gerhardt T (1996) Esophageal manometry. In: Stocks J, Sly PD, Tepper RS, Morgan WJ (eds) Infant respiratory function testing. Wiley, New york, pp 250–254

Downes JJ, Raphaely R (1975) Pediatric intensive care. Anesthesiology 43:238–250PubMedCrossRef

Kyroussis D, Polkey MI, Hamnegard CH, Mills GH, Green M, Moxham J (2000) Respiratory muscle activity in patients with COPD walking to exhaustion with and without pressure support. Eur Respir J 15:649–655PubMedCrossRef

10.

Padman R, Lawless L, von Nessen S (1994) Use of BiPAP by nasal mask in the treatment of respiratory insufficiency in pediatric patients. Pediatr Pulmonol 17:119–123PubMedCrossRef

11.

Fortenberry JD, Del Toro J, Jefferson LS, Evey L, Haase D (1995) Management of pediatric acute hypoxemic respiratory insufficiency with bilevel positive pressure (BiPAP) nasal mask ventilation. Chest 108:1059–1064PubMedCrossRef

12.

Javouhey E, Barats A, Richard N, Stamm D, Floret D (2008) Non-invasive ventilation as primary ventilatory support for infants with severe bronchiolitis. Intensive Care Med 34:1608–1614PubMedCrossRef

Titel: Feasibility of non-invasive pressure support ventilation in infants with respiratory failure after extubation: a pilot study
verfasst von: Pascal Stucki
Marie-Hélène Perez
Pietro Scalfaro
Quentin de Halleux
François Vermeulen
Jacques Cotting
Publikationsdatum: 01.09.2009
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 9/2009
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-009-1536-y

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Feasibility of non-invasive pressure support ventilation in infants with respiratory failure after extubation: a pilot study