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Clinical Profile and Outcome of Children Requiring Noninvasive Ventilation (NIV)

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Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objectives

To determine the clinical profile and outcome of children requiring noninvasive ventilation (NIV) in a PICU.

Methods

This prospective observational study was conducted in the PICU at Dayanand Medical College and Hospital, Punjab. Children (1 mo–18 y) with moderate-to-severe respiratory distress who received NIV during one-year period were included. Failure was defined as the need for endotracheal intubation. The patients received bilevel positive airway pressure (BiPAP) with inspiratory and expiratory positive airway pressure (8–18 cm H2O and 4–8 cm), respectively and indigenous continuous positive airway pressure (CPAP) were included. Vital signs (heart rate, respiratory rate) and gasometric parameters (pH, HCO3, pCO2, pO2) were recorded.

Results

Out of total 115 patients, 81.7% were successfully treated by NIV whereas 18.3% constituted NIV failure group. Two types of NIV were used, 65.2% were started on BiPAP and 34.8% on indigenous bubble CPAP. Most common diagnosis was tropical fever (24.3%), bronchopneumonia (20%), and sepsis with multiple organ dysfunction syndrome (MODS) (7.8%). Commonest indication of NIV was respiratory distress (70.4%) and prevention of postextubation respiratory failure (20.8%). Seven patients (6.9%) died during the study. NIV failure is higher in children with sepsis with MODS, abnormal blood gas (acidosis), and moderate-to-severe acute respiratory distress syndrome (ARDS).

Conclusions

This study demonstrates that NIV is an effective form of respiratory support for children with acute respiratory distress/failure. Sepsis with MODS, acidosis and ARDS (moderate to severe) were predictors of NIV failure. Careful patient selection may help in judicious use of NIV in PICU.

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Acknowledgements

The authors wish to thank Dr Deepak Bhat, Dr GS Dhooria, Dr Goraya, Dr Kamal A., and Dr Shruti Kakkar for their constant encouragement and the PICU nurses for their contribution in the patient care.

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Authors and Affiliations

  1. Department of Pediatrics, Dayanand Medical College and Hospital, Ludhiana, Punjab, 141008, India

    Daisy Punn, Karambir Singh Gill, Siddharth Bhargava & Puneet A. Pooni

Authors
  1. Daisy Punn
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  2. Karambir Singh Gill
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  3. Siddharth Bhargava
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  4. Puneet A. Pooni
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Contributions

PAP conceived this study; DP, SB helped with data collection and analysis; and PAP, KSG prepared the manuscript. All authors approved the manuscript before submitting. PAP will act as the guarantor for this paper.

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Correspondence to Karambir Singh Gill.

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Punn, D., Gill, K.S., Bhargava, S. et al. Clinical Profile and Outcome of Children Requiring Noninvasive Ventilation (NIV). Indian J Pediatr 89, 466–472 (2022). https://doi.org/10.1007/s12098-021-03965-5

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  • DOI: https://doi.org/10.1007/s12098-021-03965-5

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