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Open Access 01-12-2010 | Research article

Non invasive ventilation after extubation in paediatric patients: a preliminary study

Authors: Juan Mayordomo-Colunga, Alberto Medina, Corsino Rey, Andrés Concha, Sergio Menéndez, Marta Los Arcos, Irene García

Published in: BMC Pediatrics | Issue 1/2010

Abstract

Background

Non-invasive ventilation (NIV) may be useful after extubation in children. Our objective was to determine postextubation NIV characteristics and to identify risk factors of postextubation NIV failure.

Methods

A prospective observational study was conducted in an 8-bed pediatric intensive care unit (PICU). Following PICU protocol, NIV was applied to patients who had been mechanically ventilated for over 12 hours considered at high-risk of extubation failure -elective NIV (eNIV), immediately after extubation- or those who developed respiratory failure within 48 hours after extubation -rescue NIV (rNIV)-. Patients were categorized in subgroups according to their main underlying conditions. NIV was deemed successful when reintubation was avoided. Logistic regression analysis was performed in order to identify predictors of NIV failure.

Results

There were 41 episodes (rNIV in 20 episodes). Success rate was 50% in rNIV and 81% in eNIV (p = 0.037). We found significant differences in univariate analysis between success and failure groups in respiratory rate (RR) decrease at 6 hours, FiO₂ at 1 hour and PO₂/FiO₂ ratio at 6 hours. Neurologic condition was found to be associated with NIV failure. Multiple logistic regression analysis identified no variable as independent NIV outcome predictor.

Conclusions

Our data suggest that postextubation NIV seems to be useful in avoiding reintubation in high-risk children when applied immediately after extubation. NIV was more likely to fail when ARF has already developed (rNIV), when RR at 6 hours did not decrease and if oxygen requirements increased. Neurologic patients seem to be at higher risk of reintubation despite NIV use.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2431/10/29/prepub

Title: Non invasive ventilation after extubation in paediatric patients: a preliminary study
Authors: Juan Mayordomo-Colunga
Alberto Medina
Corsino Rey
Andrés Concha
Sergio Menéndez
Marta Los Arcos
Irene García
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: BMC Pediatrics / Issue 1/2010
Electronic ISSN: 1471-2431
DOI: https://doi.org/10.1186/1471-2431-10-29

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Non invasive ventilation after extubation in paediatric patients: a preliminary study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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