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Treatment of acute respiratory failure by prolonged non-invasive ventilation in a child

Canadian Journal of Anaesthesia volume 44, pages 727–731 (1997)Cite this article

Abstract

Purpose

To evaluate the feasibility and the efficacy of non-invasive ventilation (NIV) by nasal mask in a paediatric patient.

Clinical features

A four-year-old girl with acute lymphocytic leukaemia (ALL L1 pre-pre B) complicated by acute respiratory failure was treated with NIV On admission she exhibited hyperpyrexia (40C), pancytopaenia and severe hypoxia with hypocapnia (PaO2 = 45 minHg; PaCO2 = 28.2 mmHg; pH = 7.30; SpO2 = 76%; ABE = −7.3 mmol · L−1. With NIV, PaO2 improved (PaO2 = 78 ± 8 mmHg; SpO2 = 86 ± 2; PaCO2 = 39 ± 2) throughout the first day. Treatment was continued for six days until the patient was discharged. No complications were recorded.

Conclusion

Non-invasive ventilation by nasal mask may represent a choice in the treatment of acute respiratory failure of parenchymal origin in paediatric haematological patients.

Résumé

Objectif

Évaluer la faisabilité et l’efficacité de la ventilation non invasive (VIN) administrée par masque nasal en pédiatrie.

Éléments cliniques

Une fillette de quatre ans atteinte de leucémie lymphocytaire aiguë (ALL L1 prepre B) compliquée d’une insuffisance respiratoire aiguë a été traitée par VIN. À l’admission, elle était hyperpyrexique et profondément hypoxémique avec de l’hypocapnie (PaO2 = 45 mmHg; PaCO2 = 28, 2 mmHg; pH = 7, 30; SPO2 = 76%; ABE = −7, 3 mmol · L−1. La première journée, sous VIN, sa condition s’est améliorée (PaO2 = 78 mmHg; SPO2 = 86±2; PaCO2 = 39±2). La ventilation a été continuée pendant six jours jusqu’au congé de la patiente. II n’y a pas eu de complications.

Conclusion

La ventilation non invasive par masque nasal peut représenter une option thérapeutique valable de l’insuffisance respiratoire aiguë d’origine parenchymateuse en hématologie pédiatrique.

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Affiliations

  1. Institute of Anaesthesia and Intensive Care, University of Rome “La Sapienza”, Policlinico Umberto I, 00155, Rome, Italy

    Paola Marino, Giovanni Rosa, Giorgio Conti & Andrea A. Cogliati

Authors
  1. Paola Marino
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  2. Giovanni Rosa
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  3. Giorgio Conti
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  4. Andrea A. Cogliati
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Marino, P., Rosa, G., Conti, G. et al. Treatment of acute respiratory failure by prolonged non-invasive ventilation in a child. Can J Anaesth 44, 727–731 (1997). https://doi.org/10.1007/BF03013386

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Keywords

  • Acute Respiratory Failure
  • Mercaptopurine
  • Nasal Mask
  • Chronic Respiratory Failure
  • Acute Lymphocytic Leukaemia