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Home noninvasive ventilation: what does the anesthesiologist need to know?
Karen A Brown1, Gianluca Bertolizio, Marisa Leone
1Division of Pediatric Anesthesia, Department of Pediatric Respiratory Therapy, McGill University Health Center Research Institute, Montreal Children's Hospital, Montreal, Quebec, Canada. roula.cacolyris@muhc.mcgill.ca
Anesthesiology
|July 17, 2012
Summary
Noninvasive ventilation (NIV) is crucial for pediatric chronic respiratory failure. Understanding biomedical device design is essential for safe NIV therapy, especially for children using home systems during hospitalization.
Area of Science:
- Pediatric critical care medicine
- Biomedical engineering
- Anesthesiology
Background:
- Noninvasive ventilation (NIV) is a standard treatment for pediatric chronic respiratory failure.
- Home NIV systems are increasingly used, necessitating perioperative management guidelines.
- Knowledge of biomedical device design is critical for safe NIV therapy prescription.
Purpose of the Study:
- To review indications for home NIV therapy.
- To provide an overview of available NIV medical devices.
- To discuss perioperative management challenges for anesthesiologists.
Main Methods:
- Literature review of NIV indications and devices.
- Analysis of medical device design requirements (ISO).
- Discussion of anesthesiology management conundrums.
Main Results:
- Home NIV is common in pediatric chronic respiratory failure.
- Standardized medical device design requirements can guide safe NIV prescription.
- Anesthesiologists face specific challenges in managing these patients.
Conclusions:
- A framework based on ISO medical device design requirements can rationalize safe NIV prescription for hospitalized children on home NIV.
- Further guidelines are needed for perioperative management of pediatric patients using home NIV systems.
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