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Noninvasive Respiratory Support in Pediatric Acute Respiratory Distress Syndrome

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Pediatric Acute Respiratory Distress Syndrome

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Abstract

Invasive mechanical ventilation (IMV) is the predominant mode of respiratory support for children with acute respiratory failure and PARDS, but potential risks including ventilator-associated lung injury, nosocomial infections, airway complications, and need for potentially harmful neurosedatives and muscle relaxants make consideration of alternative, noninvasive modes of respiratory support especially important. The use of noninvasive ventilation (NIV) in pediatric acute respiratory failure has significantly increased over the last two decades. Children successfully managed with NIV have shorter lengths of stay, shorter duration of ventilatory support, and decreased mortality compared to children treated with invasive ventilation. Noninvasive respiratory support is provided using either positive pressure or negative pressure ventilation. Noninvasive positive pressure ventilation (NPPV) is commonly provided using an interface that delivers continuous positive airway pressure (CPAP) or bilevel intermittent positive airway pressure (BiPAP). Negative pressure ventilation (NPV) refers to the application of a constant or biphasic negative pressure above the chest wall using a cuirass. In both instances, air flows into the lungs, resulting in lung recruitment and improvement of gas exchange. Careful patient selection is paramount for the success of NIV in children. Team approach and familiarity with different modalities of NIV is critical. In this chapter, we describe the different modalities of NIV used to support children with acute respiratory failure and PARDS and the most pertinent evidence supporting their efficacy, advantage, disadvantages, and outcomes.

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Authors and Affiliations

  1. Division of Pediatric Critical Care Medicine, Department of Pediatrics, Oishei Children’s Hospital, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA

    Omar Alibrahim

  2. Division of Pediatric Critical Care Medicine, UH Rainbow Babies & Children’s Hospital, Case Western Reserve University School of Medicine, Cleveland, Cleveland, OH, USA

    Katherine Slain

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  1. Omar Alibrahim
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  2. Katherine Slain
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Correspondence to Omar Alibrahim .

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Editors and Affiliations

  1. Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, OH, USA

    Steven L. Shein

  2. Duke University School of Medicine, Duke University Medical Center, Durham, NC, USA

    Alexandre T. Rotta

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Alibrahim, O., Slain, K. (2020). Noninvasive Respiratory Support in Pediatric Acute Respiratory Distress Syndrome. In: Shein, S., Rotta, A. (eds) Pediatric Acute Respiratory Distress Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-030-21840-9_9

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  • DOI: https://doi.org/10.1007/978-3-030-21840-9_9

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