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Complex Failure of NIV in Children: Looking Beyond Intubation to Clinically Meaningful Outcomes
Abstract   Peer reviewed

Complex Failure of NIV in Children: Looking Beyond Intubation to Clinically Meaningful Outcomes

Natalie Napolitano, Yuan An, Danielle Traynor, Nancy-Ann Kelly, Guillaume Emeriaud and Akira Nishisaki
Critical care medicine, v 52(1), pp S307-S307
Jan 2024
DOI: https://doi.org/10.1097/01.ccm.0001000844.41276.14
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https://doi.org/10.1097/01.ccm.0001000844.41276.14View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Restricted

Abstract

Aims & Objectives: To explore the association between length of noninvasive ventilation, PICU length of stay (LOS) with the length of pediatric noninvasive ventilation failure. Methods: Observational prospective cohort study (2015-2019). We observed children during PICU stay who failed noninvasive ventilation due to acute respiratory failure. Results: A total of 109 patients with a median age of 7 months were included. Demographic variables, pediatric index of mortality (PIM2), pediatric acute respiratory distress syndrome (PARDS) diagnosis, NIV duration (categorized in early, intermediate and late), length of invasive ventilation, PICU LOS and hospital LOS was collected. The main diagnosis was pneumonia (89.9%), PARDS was diagnosed in 37.6% of the sample. No association was found between NIV duration and length of invasive ventilation after Kaplan-Meier analysis (Log rank p-value= 0.479). There was no significant difference between PICU LOS (p-value= 0.253) nor hospital LOS (p-value= 0.669) and NIV duration before intubation. PARDS diagnosis (HR 0.64 [IC95% 0.42; 0.99]) was identified as a risk factors of increased length of invasive ventilation after univariate analysis. Conclusions: No association was found between NIV duration (early, intermediate and late) and an increased length of invasive ventilation in pediatric NIV failure patients. There was no significant difference between PICU LOS, hospital LOS and NIV duration before intubation. PARDS diagnosis was identified as risk factors (pre-IMV) of increased length of invasive ventilation.

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