Noninvasive Positive Pressure Ventilation in Critically Ill Children With Cardiac Disease
Autor: | Peter Skrak, Martin Zahorec, Dusan Dobos, Lubica Kovacikova |
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Rok vydání: | 2013 |
Předmět: |
Male
Adolescent Heart Diseases Respiratory rate Critical Illness medicine.medical_treatment Intensive Care Units Pediatric pCO2 Positive-Pressure Respiration Fraction of inspired oxygen Positive airway pressure medicine Humans Intubation Prospective Studies Child Noninvasive Ventilation Respiratory distress business.industry Tracheal intubation Infant Newborn Infant Treatment Outcome Respiratory failure Child Preschool Anesthesia Pediatrics Perinatology and Child Health Female Respiratory Insufficiency Cardiology and Cardiovascular Medicine business Follow-Up Studies |
Zdroj: | Pediatric Cardiology. 35:676-683 |
ISSN: | 1432-1971 0172-0643 |
Popis: | Noninvasive ventilation is effective in respiratory failure from various etiologies. This study aimed to analyze the efficacy of noninvasive positive pressure ventilation (NPPV) in pediatric cardiac patients. NPPV was used (1) as an alternative means of respiratory support in patients with hypoxemic or hypercarbic respiratory failure or with signs of respiratory distress that were considered to require intubation; or (2) as a preventive measure in patients with high risk for extubation failure. Between 2008 and 2011, there were 107 episodes of NPPV use in 82 patients. Their median age was 57 days (range 1 day to 18 years), and weight was 4.1 kg (range 1.7-68). Within the first hour of NPPV, partial pressure of carbon dioxide/fraction of inspired oxygen (PaO2/FiO2) was significantly increased, and arterial pCO2, and respiratory rate were decreased. This decrease in respiratory rate and increase in PaO 2/FiO2 continued during the first 24 h of therapy, and pCO2 was decreased during the first 6 h. In 59.8% of cases, NPPV was successfully used without the need for tracheal intubation. The Aristotle Basic Complexity score, presence of infection, residual cardiac defect, and pH7.36 in the first hour were independent predictors of NPPV failure. We conclude that NPPV improved oxygenation and decreased respiratory effort in pediatric cardiac patients, 59.8% of whom eventually did not receive intubation. A high-complexity surgical score, presence of infection, residual cardiac defect, and pH7.36 in the first hour are predictors of NPPV failure, which occurs in most patients24 h after the onset of therapy. |
Databáze: | OpenAIRE |
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