Intensive Care Medicine

, Volume 35, Issue 8, pp 1420–1427

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

  • Marco Piastra
  • Daniele De Luca
  • Domenico Pietrini
  • Silvia Pulitanò
  • Sonia D’Arrigo
  • Aldo Mancino
  • Giorgio Conti
Pediatric Original

DOI: 10.1007/s00134-009-1558-5

Cite this article as:
Piastra, M., De Luca, D., Pietrini, D. et al. Intensive Care Med (2009) 35: 1420. doi:10.1007/s00134-009-1558-5

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.

Keywords

Noninvasive ventilationChildrenPICUARDS

Supplementary material

134_2009_1558_MOESM1_ESM.doc (26 kb)
Supplementary material (DOC 26 kb)

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Marco Piastra
    • 1
  • Daniele De Luca
    • 1
  • Domenico Pietrini
    • 1
  • Silvia Pulitanò
    • 1
  • Sonia D’Arrigo
    • 1
  • Aldo Mancino
    • 1
  • Giorgio Conti
    • 1
  1. 1.Pediatric Intensive Care Unit, Department of Anaesthesiology and Intensive CareCatholic University of the Sacred Heart, University Hospital “A.Gemelli”RomeItaly