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Intensive Care Med. 2009 Aug;35(8):1420-7. doi: 10.1007/s00134-009-1558-5. Epub 2009 Jun 23.

Noninvasive pressure-support ventilation in immunocompromised children with ARDS: a feasibility study.

Author information

1
Pediatric Intensive Care Unit, Department of Anaesthesiology and Intensive Care, Catholic University of the Sacred Heart, University Hospital A.Gemelli, L.go A. Gemelli 8, 00168 Rome, Italy.

Abstract

OBJECTIVE:

To verify the feasibility of non-invasive ventilation (NIV) in immunocompromised children affected by ARDS.

SETTING:

University Hospital PICU.

PATIENTS:

Twenty-three consecutive immunocompromised children treated with NIV for ARDS.

INTERVENTIONS:

All consecutive patients received NIV through a face-mask or a helmet.

RESULTS:

No differences were found regarding admission data and severity scores between NIV responders and non-responders. Early and sustained improvement in PaO2/FiO2 ratio were observed in 82 and 74% of cases, respectively. 13 out of 23 patients (54.5%) avoided intubation and were discharged from the PICU; ten patients required intubation: two of them survived and eight patients died (two refractory hypoxemia, three septic shock, three multi-organ failure). PICU and intra-hospital mortality was significantly higher for NIV-nonresponders (P < 0.001). PICU stay was significantly shorter for NIV responders (P = 0.03). NIV responders had significantly lower heart and respiratory rate at the end of treatment (P < 0.001 and P = 0.048, respectively).

CONCLUSIONS:

NIV administration is feasible and well tolerated in immunocompromised children with ARDS. A short NIV trial can be used to verify the usefulness of the technique. A randomized controlled trial is needed to confirm the efficacy of NIV in immunocompromised children requiring ventilatory support for ARDS.

PMID:
19547952
DOI:
10.1007/s00134-009-1558-5
[Indexed for MEDLINE]

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