lticentered study on efficiency of noninvasive ventilation procedures(SAFE-NIV)

Authors

EBRU ATİKE ONGUN
OĞUZ DURSUN
AYŞE BERNA ANIL
ÜMÜT ALTUĞ
ÖZLEM TEMEL KÖKSOY
BAŞAKNUR AKYILDIZ
SERKAN ÖZSOYLU
TANIL KENDİRLİ
SERHAN ÖZCAN
RIZA DİNÇER YILDIZDAŞ
İLKNUR TOLUNAY
BÜLENT KARAPINAR
MEHMET ARDA KILINÇ
DEMET DEMİRKOL

DOI

10.3906/sag-2004-35

Abstract

Background/aim: To characterize the clinical course of noninvasive positive pressure ventilation (NIPPV) and high flow humidified nasal cannula ventilation (HFNC) procedures; perform risk analysis for ventilation failure. Material and methods: This prospective, multi-centered, observational study was conducted in 352 PICU admissions (1 month-18 years) between 2016 and 2017. SPSS-22 was used to assess clinical data, define thresholds for ventilation parameters and perform risk analysis. Results: Patient age, onset of disease, previous intubation and hypoxia influenced the choice of therapy mode: NIPPV was preferred in older children (p = 0.002) with longer intubation (p < 0.001), ARDS (p = 0.001), lower respiratory tract infections (p < 0.001), chronic respiratory disease, (p = 0.005), malignancy (p = 0.048) and immune deficiency (p = 0.026). The failure rate was 13.4%. sepsis, ARDS, prolonged intubation, and use of nasal masks were associated with NIV failure (p = 0.001, p < 0.001, p < 0.001, p = 0.025). The call of intubation or re-intubation was given due to respiratory failure in twenty-seven (57.5%), hemodynamic instability in eight (17%), bulbar dysfunction or aspiration in 5 (10.6%), neurological deterioration in 4 (8.5%) and developing ARDS in 3 (6.4%) children. A reduction of less than 10% in the respiration within an hour increased the odds of failure by 9.841 times (OR: 9.841, 95% CI: 2.0021-48.3742). FiO2 > 55% at 6th hours and PRISM-3 >8 were other failure predictors. Of the 9.9% complication rate, the most common complication was pressure ulcerations (4.8%) and mainly observed when using full-face masks (p = 0.047). Fifteen (4.3%) patients died of miscellaneous causes. Tracheostomy cannulation was performed on 16 children due to prolonged mechanical ventilation (8% in NIPPV, 2.6% in HFNC) Conclusion: Absence of reduction in the respiration rate within an hour, FiO2 requirement >55% at 6th hours and PRISM-3 score >8 predict NIV failure.

Keywords

HFNC, noninvasive positive pressure ventilation, children, respiratory failure.

First Page

1159

Last Page

1171

Recommended Citation

ONGUN, EBRU ATİKE; DURSUN, OĞUZ; ANIL, AYŞE BERNA; ALTUĞ, ÜMÜT; KÖKSOY, ÖZLEM TEMEL; AKYILDIZ, BAŞAKNUR; ÖZSOYLU, SERKAN; KENDİRLİ, TANIL; ÖZCAN, SERHAN; YILDIZDAŞ, RIZA DİNÇER; TOLUNAY, İLKNUR; KARAPINAR, BÜLENT; KILINÇ, MEHMET ARDA; and DEMİRKOL, DEMET (2021) "lticentered study on efficiency of noninvasive ventilation procedures(SAFE-NIV)," Turkish Journal of Medical Sciences: Vol. 51: No. 3, Article 32. https://doi.org/10.3906/sag-2004-35
Available at: https://journals.tubitak.gov.tr/medical/vol51/iss3/32