Non-Invasive Ventilation in Infants Attending a Tertiary Care Center: A Retrospective Review
PDF

Keywords

Apnea
Infants
Length of Stay
Non-invasive Ventilation
Respiratory Distress

Categories

How to Cite

1.
Alsharif S. Non-Invasive Ventilation in Infants Attending a Tertiary Care Center: A Retrospective Review. Integr J Med Sci [Internet]. 2021 Aug. 2 [cited 2024 Nov. 18];8. Available from: https://mbmj.org/index.php/ijms/article/view/405

Abstract

Bronchiolitis was found to be the greatest worldwide cause of infant hospitalization presenting with symptoms of cough, wheezes, difficulty in breathing, decreased feeding, and apneas. It is estimated that 1-3% of hospitalized infants will require treatment in an intensive care unit especially when risk factors are present. This study analyzes the use of Non-invasive ventilation (NIV) in severe bronchiolitis and its role in reducing the rate of ventilator associated pneumonia (VAP), and the duration of oxygen requirement. Data were collected retrospectively through PHENIX; hospital electronic system for infants less than one year old. Shortness of breath, cough, apnea, cyanosis, N-CPAP immediate or later after few hours, mechanical ventilation (MV), length of hospital stay, and survival status were the outcome variables. Mann-Whitney U test was performed via SPSS version 25.0.Fifty-five infants with bronchiolitis were admitted with forty-nine episodes receiving NIV or MV. A total of thirty-seven infants were treated with NIV while 15 infants were treated with MV. Fever was the major indication for initiating NIV among infants followed by cough, apnea, and shortness of breath. Insignificant evidence was reported between baseline respiratory parameters and infants receiving NIV and MV. Changes in respiratory variables in the first four hours showed significant increase for infants receiving NIV than those receiving MV. Infants receiving NIV had significantly fewer days in NIV and PICU, but insignificant fewer days in hospital stay. The experience for using NIV in infants admitted for bronchiolitis recommends that NIV might be adjunct to mechanical ventilation. This strategy was related with a lower rate of pneumonia and a shorter duration of oxygen therapy.

https://doi.org/10.15342/ijms.2021.405
PDF

References

Lazner MR, Basu AP, Klonin H. Non-invasive ventilation for severe bronchiolitis: Analysis and evidence. Pediatr Pulmonol. 2012 Sep;47(9):909-16. https://doi.org/10.1002/ppul.22513

Ganu SS, Gautam A, Wilkins B, Egan J. Increase in use of non-invasive ventilation for infants with severe bronchiolitis is associated with decline in intubation rates over a decade. Intensive Care Med. 2012 Jul;38(7):1177-83. https://doi.org/10.1007/s00134-012-2566-4

Fujiogi M, Goto T, Yasunaga H, Fujishiro J, Mansbach JM, Camargo CA Jr, et al. Trends in Bronchiolitis Hospitalizations in the United States: 2000–2016. Pediatrics. 2019 Dec;144(6):e20192614. https://doi.org/10.1542/peds.2012-3877d

Prill MM, Iwane MK, Little D, Gerber SI. Investigation of Respiratory Syncytial Virus–Associated Deaths Among US Children Aged <2 Years, 2004–2007: Table 1. J Pediatric Infect Dis Soc. 2016 Sep;5(3):333-6. https://doi.org/10.1093/jpids/piv006

Ericksen RT, Guthrie C, Carroll T. The Use of Procalcitonin for Prediction of Pulmonary Bacterial Coinfection in Children With Respiratory Failure Associated With Viral Bronchiolitis. Clin Pediatr (Phila). 2019 Mar;58(3):288-294. https://doi.org/10.1177/0009922818816432

Tagrian Esfahani M, Keshavarz K, Keshtkari A, Sadeghi Mansourkhani A, Akbartabar Toori M, Zoladl M. Effect of Caffeine on Coughing in Children Aged 3-36 Months: A Randomized Clinical Trial. J Clinic Care and Skills. 2019; 1:81-87. [Accessed 2021 Jun 21]. Available from: http://jccs.yums.ac.ir/article-1-56-en.html

Green CA, Yeates D, Goldacre A, Sande C, Parslow RC, McShane P, et al. Admission to hospital for bronchiolitis in England: trends over five decades, geographical variation and association with perinatal characteristics and subsequent asthma. Arch Dis Child. 2016 Feb;101(2):140-6. https://doi.org/10.1136/archdischild-2015-308723

Franklin D, Fraser JF, Schibler A. Respiratory support for infants with bronchiolitis, a narrative review of the literature. Paediatr Respir Rev. 2019 Apr;30:16-24. https://doi.org/10.1016/j.prrv.2018.10.001

Turnham H, Agbeko RS, Furness J, Pappachan J, Sutcliffe AG, Ramnarayan P. Non-invasive respiratory support for infants with bronchiolitis: a national survey of practice. BMC Pediatrics. 2017; 17(1). https://doi.org/10.1186/s12887-017-0785-0

Joshi N, Estes MK, Shipley K, Lee HD, Zaurova M. Noninvasive ventilation for patients in acute respiratory distress: an update [digest]. Emerg Med Pract. 2017;19:1-2.

Combret Y, Prieur G, LE Roux P, Médrinal C. Non-invasive ventilation improves respiratory distress in children with acute viral bronchiolitis: a systematic review. Minerva Anestesiol. 2017; 83:624-637. https://doi.org/10.23736/s0375-9393.17.11708-6

Agrawal R, Sumithra S, Kare J, Raj JM. Predictors of the failure of non-invasive ventilation in children with acute respiratory distress: A prospective observational study. Indian J Child Health. 2019; 6(1): 6-11. https://doi.org/10.32677/ijch.2019.v06.i01.002

Clayton JA, McKee B, Slain KN, Rotta AT, Shein SL. Outcomes of Children With Bronchiolitis Treated With High-Flow Nasal Cannula or Noninvasive Positive Pressure Ventilation. Pediatr Crit Care Med. 2019 Feb;20(2):128-135. https://doi.org/10.1097/pcc.0000000000001798

Macnab AJ, Macrae DJ, Henning RJ. Care of the critically ill child. Saunders; 1999.

Flamant C, Hallalel F, Nolent P, Chevalier JY, Renolleau S. Severe respiratory syncytial virus bronchiolitis in children: from short mechanical ventilation to extracorporeal membrane oxygenation. Eur J Pediatr. 2005 Feb;164(2):93-8. https://doi.org/10.1007/s00431-004-1580-0

Smith A, Kelly DP, Hurlbut J, Melvin P, Russ CM. Initiation of Noninvasive Ventilation for Acute Respiratory Failure in a Pediatric Intermediate Care Unit. Hosp Pediatr. 2019 Jul;9(7):538-544. https://doi.org/10.1542/hpeds.2019-0034

Rajapreyar P, Kopp W, Randolph A. Acute Respiratory Failure and Management. Critic Care Pediatric Immunocompromised Hematology/ Oncology Patient. 2019;195–210.

Hosheh O, Wang J. Does caffeine prevent intubation in babies with bronchiolitis who present with apnoea? Arch Dis Child. 2019; 104 (10):1016-1018. https://doi.org/10.1136/archdischild-2019-317668

Ilarslan NEC, Gunay F, Haskologlu ZS, Bal SK, Tezcaner ZC, Kirsaclioglu CT, et al. Evaluation of children with chronic cough including obstructive sleep apnea: a single-center experience. Europ J Pediatr. 2018; 178 (2):189-197. https://doi.org/10.1007/s00431-018-3276-x

Rostad A. Respiratory Syncytial Virus: Spectrum of Clinical Manifestations and Complications in Children. Pediatr Ann. 2019;48(9): e349–e353. https://doi.org/10.3928/19382359-20190815-01

Jat KR, Mathew JL. Continuous positive airway pressure (CPAP) for acute bronchiolitis in children. Cochrane Database Syst Rev. 2015 Jan 7;1:CD010473. https://doi.org/10.1002/14651858.cd010473

Mayordomo-Colunga J, Rey C, Medina A, Martínez-Camblor P, Vivanco-Allende A, Concha A. Helmet Versus Nasal-Prong CPAP in Infants With Acute Bronchiolitis. Respir Care. 2018 Apr;63(4):455-463. https://doi.org/10.4187/respcare.05840

Manso Ruiz de la Cuesta R, Del Villar Guerra P, Medina Villanueva A, Modesto Alaport V, Molinos Norniella C, Bartolomé Albistegui MJ, et al. CPAP vs therapy in infants being transported due to acute respiratory failure. An Pediatr (Engl Ed). 2020 Sep;93(3):152-160. https://doi.org/10.1016/j.anpede.2019.07.004

Lal SN, Kaur J, Anthwal P, Goyal K, Bahl P, Puliyel JM. Nasal continuous positive airway pressure in bronchiolitis: A randomized controlled trial,” Indian Pediatr. 2018 Jan 15;55(1):27-30. https://doi.org/10.1007/s13312-018-1222-7

Vahlkvist S, Jürgensen L, la Cour A, Markoew S, Petersen TH, Kofoed PE. High flow nasal cannula and continuous positive airway pressure therapy in treatment of viral bronchiolitis: a randomized clinical trial. Eur J Pediatr. 2020 Mar;179(3):513-518. https://doi.org/10.1007/s00431-019-03533-2

Cunningham S. Respiratory Support in Bronchiolitis: Trial Evidence Am J Perinatol. 2018 May;35(6):553-556. https://doi.org/10.1055/s-0038-1637765

Gonzalez-Pardo O, Cassalett-Bustillo G. Extracorporeal membrane oxygenation (ECMO) for pediatric respiratory failure due to respiratory syncytial virus infection. Pediatr infect dis. vol. 2016 ;3: 1-2. https://doi.org/10.21767/2573-0282.100015

Wolfler A, Raimondi G, Pagan de Paganis C, Zoia E. The infant with severe bronchiolitis: from high flow nasal cannula to continuous positive airway pressure and mechanical ventilation. Minerva Pediatr. 2018 Dec;70(6):612-622. https://doi.org/10.23736/s0026-4946.18.05358-6

Garcia-Mauriño C, Moore-Clingenpeel M, Wallihan R, Koranyi K, Rajah B, Shirk T, et al. Discharge criteria for bronchiolitis: an unmet need. Pediatr Infect Dis J. 2018 Jun;37(6):514-519. https://doi.org/10.1097/inf.0000000000001836

Frat JP, Coudroy R, Marjanovic N, Thille AW. High-flow nasal oxygen therapy and noninvasive ventilation in the management of acute hypoxemic respiratory failure. Ann Transl Med. 2017 Jul;5(14):297. https://doi.org/10.1186/2197-425x-3-s1-a98

Hsia CC, Hyde DM, Weibel ER. Lung structure and the intrinsic challenges of gas exchange. Compr Physiol. 2016 Mar 15;6(2):827-95. https://doi.org/10.1002/cphy.c150028

Díaz MG, García RP, Gamero DB, González-Tomé MI, Romero PC, Ferrer MM. et al. Lack of accuracy of biomarkers and physical examination to detect bacterial infection in febrile infants. Pediatr Emerg Care. 2016 Oct;32(10):664-668. https://doi.org/10.1097/pec.0000000000000401

Tasker RC. CPAP and HFOV: different guises of the same underlying intensive care strategy for supporting RSV bronchiolitis. Intensive Care Med. 2008 Sep;34(9):1560-1.https://doi.org/10.1007/s00134-008-1152-2

Dong M, Zhou Y, Yang J, Yang J, Liao X, Kang Y, et al. Compare the effect of noninvasive ventilation and tracheotomy in critically ill mechanically ventilated neurosurgical patients: a retrospective-observed cohort study. BMC Neurol. 2019 May 1;19(1):79. https://doi.org/10.1186/s12883-019-1297-3

Wang T, Zhang L, Luo K, He J, Ma Y, Li Z, et al. Noninvasive versus invasive mechanical ventilation for immunocompromised patients with acute respiratory failure: a systematic review and meta-analysis. BMC Pulm Med. 2016 Aug 27;16(1):129. https://doi.org/10.1186/s12890-016-0289-y

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2021 Shafiqa Alsharif

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...