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Published in: Intensive Care Medicine 9/2008

01-09-2008 | Original

Non-invasive ventilation as primary ventilatory support for infants with severe bronchiolitis

Authors: Etienne Javouhey, Audrey Barats, Nathalie Richard, Didier Stamm, Daniel Floret

Published in: Intensive Care Medicine | Issue 9/2008

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Abstract

Objective

To report our experience of non-invasive ventilation (NIV) as primary ventilatory support strategy in infants admitted for severe bronchiolitis.

Design and setting

Retrospective study in a paediatric intensive care unit of an university hospital.

Patients

Infants aged less than 12 months, admitted for bronchiolitis during 2003–2004 and 2004–2005 winter epidemics.

Intervention

NIV was used as the primary ventilatory support during the second winter (NIV period), whereas invasive ventilation (IV) was the only support employed during the first winter (IV period). NIV consisted in either continuous positive airway pressure (CPAP from 5 to 10 cmH2O) or bilevel positive airway pressure (inspiratory pressure from 12 to 18 cmH2O) with a nasal mask.

Results

During the IV period, 53 infants were included, compared to 27 during the NIV period. The two groups did not differ in age or in number of premature births. Children in NIV group had less apnoea on admission. The intubation rate was reduced during NIV period (p < 0.001). No children had ventilator-associated pneumonia (VAP) during NIV period compared to nine during IV period (p < 0.05). In the NIV group, 10 infants (37%) required supplemental oxygen for more than 8 days compared to 33 children (65%) in IV group (p < 0.05). The length of hospital stay and the duration of ventilation were similar.

Conclusions

In this retrospective study, the use of NIV decreased the rate of ventilator associated pneumonia and reduced the duration of oxygen requirement without prolonging the hospital stay.
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Metadata
Title
Non-invasive ventilation as primary ventilatory support for infants with severe bronchiolitis
Authors
Etienne Javouhey
Audrey Barats
Nathalie Richard
Didier Stamm
Daniel Floret
Publication date
01-09-2008
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 9/2008
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-008-1150-4

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