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01.03.2009 | Pediatric Original

Predictive factors of non invasive ventilation failure in critically ill children: a prospective epidemiological study

verfasst von: Juan Mayordomo-Colunga, Alberto Medina, Corsino Rey, Juan José Díaz, Andrés Concha, Marta Los Arcos, Sergio Menéndez

Erschienen in: Intensive Care Medicine | Ausgabe 3/2009

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Abstract

Objective

Identification of predictive factors for non-invasive ventilation (NIV) failure and determination of NIV characteristics.

Design

Prospective observational study.

Setting

Paediatric Intensive Care Unit in a University Hospital.

Patients and measurements

A total of 116 episodes were included. Clinical data collected were respiratory rate (RR), heart rate and FiO₂ before NIV began. Same data and expiratory and support pressures were collected at 1, 6, 12, 24 and 48 h. Conditions precipitating acute respiratory failure (ARF) were classified into two groups: type 1 (38 episodes) and type 2 (78 episodes). Ventilation–perfusion impairment was the main respiratory failure mechanism in type 1, and hypoventilation in type 2. Factors predicting NIV failure were determined by multivariate analysis.

Results

Most common admission diagnoses were pneumonia (81.6%) in type 1 and bronchiolitis (39.7%) and asthma (42.3%) in type 2. Complications secondary to NIV were detected in 23 episodes (20.2%). NIV success rate was 84.5% (68.4% in type 1 and 92.3% in type 2). Type 1 patients showed a higher risk of NIV failure compared to type 2 (OR 11.108; CI 95%, 2.578–47.863). A higher PRISM score (OR 1.138; CI 95%, 1.022–1.267), and a lower RR decrease at 1 h and at 6 h (OR 0.926; CI 95%, 0.860–0.997 and OR 0.911; CI 95%, 0.837–0.991, respectively) were also independently associated with NIV failure.

Conclusions

NIV is a useful respiratory support technique in paediatric patients. Type 1 group classification, higher PRISM score, and lower RR decrease during NIV were independent risk factors for NIV failure.

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Titel: Predictive factors of non invasive ventilation failure in critically ill children: a prospective epidemiological study
verfasst von: Juan Mayordomo-Colunga
Alberto Medina
Corsino Rey
Juan José Díaz
Andrés Concha
Marta Los Arcos
Sergio Menéndez
Publikationsdatum: 01.03.2009
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 3/2009
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-008-1346-7

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Predictive factors of non invasive ventilation failure in critically ill children: a prospective epidemiological study