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Respiratory Modalities in Preventing Reintubation in a Pediatric Intensive Care Unit

Ameer Al-Hadidi1, Morta Lapkus1, Patrick Karabon2

  • 1Beaumont Health, Royal Oak, MI, USA.

Global Pediatric Health
|February 22, 2021
PubMed

Insights

Therapeutic respiratory support helps prevent reintubation in pediatric intensive care units. However, patients receiving this support experienced longer intensive care unit and hospital stays.

Area of Science:

  • Pediatric Critical Care Medicine
  • Respiratory Therapy

Background:

  • Post-extubation respiratory failure is a significant cause of morbidity in pediatric intensive care units.
  • Limited data exists comparing respiratory support modalities for preventing reintubation in children.

Purpose of the Study:

  • To compare different therapeutic respiratory modalities used after extubation from mechanical ventilation in a pediatric intensive care unit.
  • To evaluate the effectiveness of various respiratory support methods in preventing reintubation.

Main Methods:

  • Retrospective review of 491 children admitted to a single-center pediatric intensive care unit from January 2010 to December 2017.
  • Analysis of patients requiring mechanical ventilation and subsequent extubation, comparing outcomes based on respiratory support received.

Main Results:

  • Therapeutic respiratory support, including high-flow nasal cannula and noninvasive positive pressure ventilation, successfully avoided reintubation in the majority of patients (80% and 100%, respectively).
  • Patients requiring therapeutic respiratory support had significantly longer Pediatric Intensive Care Unit (PICU) lengths of stay (LOS) (10.92 vs 6.91 days, P=.0357) and hospital LOS (16.43 vs 10.20 days, P=.0250).

Conclusions:

  • Therapeutic respiratory support following extubation is effective in preventing reintubation in pediatric patients.
  • While effective, the use of therapeutic respiratory support is associated with increased PICU and hospital lengths of stay.
  • Further prospective clinical trials are recommended to confirm these findings and optimize post-extubation respiratory management strategies.

Keywords:
airway extubationcritical carehigh-flow nasal cannulareintubationrespiratory failure

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