Evaluation of a Mapleson D CPAP system for weaning of mechanical ventilation in pediatric patients.

Autor: Palomero-Rodríguez MA; Department of Anesthesiology, Salamanca University Hospital, Salamanca, Spain., de Arteaga HC; Department of Medical, Merck, Mostoles University Hospital, Mostoles, Spain., Báez YL; Department of Anesthesiology, Mostoles University Hospital, Mostoles, Spain., de Vicente Sánchez J; Department of Anesthesiology, La Paz University Hospital, Madrid, Spain., Carretero PS; Department of Anesthesiology, La Paz University Hospital, Madrid, Spain., Conde PS; Department of Medical, Merck, Mostoles University Hospital, Mostoles, Spain., Pérez Ferrer A; Department of Anesthesiology, La Paz University Hospital, Madrid, Spain.
Jazyk: angličtina
Zdroj: Lung India : official organ of Indian Chest Society [Lung India] 2016 Sep-Oct; Vol. 33 (5), pp. 517-21.
DOI: 10.4103/0970-2113.188972
Abstrakt: Background: Over the last years, we have used a flow-inflating bag circuit with a nasotracheal or nasopharyngeal tube as an interface to deliver effective CPAP support in infants ("Mapleson D CPAP system"). The primary goal of this study was to assess the usefulness of the "Mapleson D CPAP system" for weaning of mechanical ventilation (MV) in infants who received MV over 24 h.
Materials and Methods: All infants who received MV for more than 24 h in the last year were enrolled in the study. Demographic data included age, gender, weight, and admission diagnosis. Heart rate, respiratory rate, blood pressure, and oxygen saturation were measured during MV, 2 h after the nasotracheal Mapleson D CPAP system and 2 h after extubation. Patients were classified into two groups: patients MV more than 48 h, and patients with MV fewer than 48 h. P < 0.05 was considered statistically significant.
Results: A total of 50 children were enrolled in the study, with a median age was 34 ± 45 months (range, 1-59 months) and median weight was 11.98 ± 9.31 kg (range, 1-48 kg). Median duration of MV was 480 h (range, 2-570). There were no significant differences in PaO2, PaCO2, and pH among MV, 2 h after the nasotracheal Mapleson D CPAP system and 2 h after extubation and spontaneous ventilation with the nasopharyngeal Mapleson D CPAP system or with nasal prongs. The overall extubation failure rate was 26% (n = 13). Weight and age were significantly associated with extubation failure (P < 0.05).
Conclusions: The Mapleson D CPAP system, in our opinion, is a useful and safe alternative to more complex and expensive noninvasive CPAP and BiPAP weaning from MV in infants.
Databáze: MEDLINE
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