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Weaning of Children With Burn Injury by Noninvasive Ventilation: A Clinical Experience

Marco Piastra1, Enzo Picconi1, Tony C Morena1

  • 1Pediatric Intensive Care Unit, Department of Intensive Care Medicine, Anesthesiology and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy.

Journal of Burn Care & Research : Official Publication of the American Burn Association
|April 30, 2019
PubMed

Insights

Severe burn injuries in children often require mechanical ventilation, significantly increasing Pediatric Intensive Care Unit (PICU) stays. Noninvasive ventilation (NIV) showed potential benefits in reducing invasive ventilation time and complications for these pediatric patients.

Area of Science:

  • Pediatric Critical Care Medicine
  • Burn Injury Management
  • Respiratory Support

Background:

  • Severe burn injuries in pediatric patients frequently necessitate respiratory support.
  • Mechanical ventilation is a common intervention in Pediatric Intensive Care Units (PICUs) for burned children.
  • The length of PICU stay is significantly influenced by the need for ventilation and burn severity.

Purpose of the Study:

  • To analyze the respiratory management strategies for infants and children with severe burn injuries admitted to a PICU.
  • To evaluate the potential benefits of noninvasive ventilation (NIV) in reducing invasive mechanical ventilation requirements and associated complications.

Main Methods:

  • Retrospective review of pediatric patients admitted to a PICU between 2009 and 2016.
  • Analysis of data including age, burn characteristics (e.g., face burns), need for tracheal intubation, PICU length of stay, and ventilation strategies.
  • Comparison of outcomes between patients who received NIV and those who did not.

Main Results:

  • 118 pediatric patients with burn injuries were included; 37.3% required tracheal intubation and 30.5% had PICU stays exceeding 7 days.
  • Ventilated patients experienced significantly longer PICU stays (13 days vs. 4.5 days).
  • Noninvasive ventilation (NIV) was used in 10 patients; no significant difference in PICU length of stay or invasive ventilation duration was observed compared to non-NIV patients, despite larger burn surface areas in the NIV group.

Conclusions:

  • Mechanical ventilation is a critical factor impacting PICU length of stay in pediatric burn patients.
  • While NIV did not show a statistically significant difference in this cohort, it may offer potential benefits in shortening invasive ventilation duration and reducing complications.
  • Further research is warranted to fully elucidate the role and efficacy of NIV in managing respiratory distress in severe pediatric burn injuries.

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