Intensive Care Medicine

, Volume 34, Issue 12, pp 2248–2255

Physiological effects of noninvasive positive ventilation during acute moderate hypercapnic respiratory insufficiency in children

  • Sandrine Essouri
  • Philippe Durand
  • Laurent Chevret
  • Vincent Haas
  • Claire Perot
  • Annick Clement
  • Denis Devictor
  • Brigitte Fauroux
Pediatric Original

Abstract

Introduction

A prospective physiological study was performed in 12 paediatric patients with acute moderate hypercapnic respiratory insufficiency to assess the ability of noninvasive positive pressure ventilation (NPPV) to unload the respiratory muscles and improve gas exchange.

Materials and methods

Breathing pattern, gas exchange, and inspiratory muscle effort were measured during spontaneous breathing and NPPV.

Results

NPPV was associated with a significant improvement in breathing pattern, gas exchange and respiratory muscle output. Tidal volume and minute ventilation increased by 33 and 17%, and oesophageal and diaphragmatic pressure time product decreased by 49 and 56%, respectively. This improvement in alveolar ventilation translated into a reduction in mean partial pressure in carbon dioxide from 48 to 40 mmHg (P = 0.01) and in respiratory rate from 48 to 41 breaths/min (P = 0.01). No difference between a clinical setting and a physiological setting of NPPV was observed. In conclusion, this study shows that NPPV is able to unload the respiratory muscles and improve clinical outcome in young patients admitted to the paediatric intensive care unit for acute moderate hypercapnic respiratory insufficiency.

Keywords

Noninvasive positive pressure ventilation Acute respiratory insufficiency Work of breathing Children 

Supplementary material

134_2008_1202_MOESM1_ESM.doc (57 kb)
MOESM1 [INSERT CAPTION HERE] (DOC 57 kb)

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Sandrine Essouri
    • 1
    • 3
  • Philippe Durand
    • 1
  • Laurent Chevret
    • 1
  • Vincent Haas
    • 1
  • Claire Perot
    • 1
  • Annick Clement
    • 2
  • Denis Devictor
    • 1
  • Brigitte Fauroux
    • 2
  1. 1.AP-HP, Pediatric Intensive Care UnitKremlin-Bicetre HospitalKremlin-BicetreFrance
  2. 2.AP-HP, Pediatric Pulmonary DepartmentArmand Trousseau HospitalParisFrance
  3. 3.Service de réanimation pédiatriqueHôpital du Kremlin-BicêtreKremlin-BicetreFrance

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