原创力文档non invasive ventilation after extubation in paediatric patients a preliminary study非侵入性通风在儿科病人拔管后的初步研究.pdfVIP
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non invasive ventilation after extubation in paediatric patients a preliminary study非侵入性通风在儿科病人拔管后的初步研究
Mayordomo-Colunga et al. BMC Pediatrics 2010, 10:29
/1471-2431/10/29
R E S E A R C H A R T I C L E Open Access
Research article
Non invasive ventilation after extubation in
paediatric patients: a preliminary study
Juan Mayordomo-Colunga*, Alberto Medina, Corsino Rey, Andrés Concha, Sergio Menéndez, Marta Los Arcos and
Irene García
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, FiO at 1 hour and PO /FiO ratio at 6 hours. Neurologic condition was found to be associated with NIV
2 2 2
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 i
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