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Utilisation of RAM cannula for non-invasive respiratory support for infants in the cardiac ICU

Ashish Saini1, Kevin O Maher2, Shriprasad R Deshpande3

  • 1Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA.

Cardiology in the Young
|April 5, 2021
PubMed

Insights

The nasal prong (RAM) cannula safely supports infants with congenital heart disease needing respiratory support, with a 69.5% success rate. Successful use can shorten intensive care unit stays.

Area of Science:

  • Pediatric Critical Care
  • Cardiology
  • Respiratory Support

Background:

  • Infants with congenital heart disease (CHD) often experience pulmonary insufficiency.
  • Prolonged ventilatory support is frequently required, particularly post-operatively.
  • Non-invasive ventilatory support is increasingly utilized for these vulnerable patients.

Purpose of the Study:

  • To evaluate the utilization of the nasal prong (RAM) cannula.
  • To assess the safety and outcomes of RAM cannula use.
  • To determine its role in escalating and de-escalating respiratory support in infants with CHD.

Main Methods:

  • A single-centre retrospective cohort study was conducted.
  • Patients were supported using the RAM cannula.
  • Data were analyzed for 275 instances of RAM cannula use, with stratification into escalation and de-escalation groups.

Main Results:

  • The overall success rate for RAM cannula use was 69.5% (66.1% in escalation, 72.8% in de-escalation).
  • Predictors of success included specific baseline and post-intervention oxygenation and ventilation parameters, and absence of chest X-ray worsening.
  • Successful RAM cannula support was linked to significantly shorter intensive care unit stays.

Conclusions:

  • The RAM cannula is a safe option for non-invasive respiratory support in infants within the cardiac ICU.
  • It can be effectively used for both escalating and de-escalating respiratory support needs.
  • Identifying success factors aids in optimizing patient selection and timing for non-invasive ventilation.
Abstract

Keywords:
Non-invasive ventilationRAM cannulacardiac intensive care post-operative carecardiorespiratory failurechildren

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