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Post-extubation non-invasive ventilation in the pediatric intensive care unit: a multicenter study
Juan P Bonora1, Judith Frydman2, Alejandra Retta3
1Hospital de Pediatría "Prof. Dr. Juan P. Garrahan". juampabon@yahoo.com.ar.
Archivos Argentinos De Pediatria
|September 12, 2018
Summary
Postextubation noninvasive ventilation (NIV) is effective in preventing reintubation. However, immunocompromised patients and those with neurological issues face higher failure rates with NIV.
Area of Science:
- Pediatric Critical Care
- Respiratory Medicine
- Mechanical Ventilation
Background:
- Extubation failure is a significant cause of increased morbidity and mortality in pediatric patients.
- Noninvasive ventilation (NIV) has emerged as an effective ventilatory support therapy.
Purpose of the Study:
- To determine the success rate of postextubation NIV.
- To identify factors associated with NIV procedural failure or success in children.
Main Methods:
- An observational, retrospective, analytical, multicenter study was conducted.
- Included were pediatric patients requiring postextubation NIV between 2014 and 2015.
- NIV failure was defined as the need for reintubation within 48 hours.
Main Results:
- Success rates for rescue and elective NIV were 68.8% and 72.7%, respectively.
- Higher mortality was observed in patients with failed rescue NIV.
- Longer hospital stays and invasive mechanical ventilation duration were noted in the elective NIV group.
Conclusions:
- Postextubation NIV can be a valuable tool to prevent reintubation.
- Immunocompromised patients and those with a neurological history exhibited higher NIV failure rates.
- NIV failure was associated with shorter NIV tolerance and longer pediatric intensive care unit stays.
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