TY - JOUR
T1 - Is a nasopharyngeal tube effective as interface to provide bi-level noninvasive ventilation?
AU - Arnaiz, Eneritz Velasco
AU - Cambra Lasaosa, Francisco José
AU - Platero, Lluïsa Hernández
AU - del Real, Núria Millán García
AU - Pons-Òdena, Martí
PY - 2014/4
Y1 - 2014/4
N2 - BACKGROUND: The nasopharyngeal tube (NT) is a potential interface for noninvasive ventilation (NIV) available in all health care centers. The aim of the study was to describe our experience in the use of the NT for bi-level NIV in infants and its effectiveness. METHODS: Prospective observational study from January 2007 to December 2010, including all patients ≤ 6 months old admitted to the pediatric ICU (PICU) and treated with NIV with two levels of pressure using the NT. Clinical data collected before starting NIV, and at 2, 8, 12 and 24 h, were analyzed following NIV initiation: first-line or initial NIV (i-NIV), elective postextubation NIV (e-NIV), and rescue postextubation NIV (r-NIV). The need for intubation was considered to be NIV failure. RESULTS: One hundred fifty-one episodes of NIV were included in the study, with 65% of patients having bronchiolitis. e-NIV was most frequently used (48%) (i-NIV 44%, r-NIV 8%), and the failure rate, 27% in total, was highest in the i-NIV group (37%) (e-NIV 18%, r-NIV 25%). Case patients with successful outcomes had shorter PICU stays (8.5 vs 13 d, P =.001) and hospital stays (17 vs 23 d, P =.03) stays. The NT needed to be changed for another interface in only 5 case patients, few complications (4 of 151 patients) were observed, and mortality (2 of 151 patients) was unrelated to NIV. CONCLUSIONS: Use of the NT showed 73% effectiveness, with few complications. The effectiveness was higher in e-NIV than i-NIV.
AB - BACKGROUND: The nasopharyngeal tube (NT) is a potential interface for noninvasive ventilation (NIV) available in all health care centers. The aim of the study was to describe our experience in the use of the NT for bi-level NIV in infants and its effectiveness. METHODS: Prospective observational study from January 2007 to December 2010, including all patients ≤ 6 months old admitted to the pediatric ICU (PICU) and treated with NIV with two levels of pressure using the NT. Clinical data collected before starting NIV, and at 2, 8, 12 and 24 h, were analyzed following NIV initiation: first-line or initial NIV (i-NIV), elective postextubation NIV (e-NIV), and rescue postextubation NIV (r-NIV). The need for intubation was considered to be NIV failure. RESULTS: One hundred fifty-one episodes of NIV were included in the study, with 65% of patients having bronchiolitis. e-NIV was most frequently used (48%) (i-NIV 44%, r-NIV 8%), and the failure rate, 27% in total, was highest in the i-NIV group (37%) (e-NIV 18%, r-NIV 25%). Case patients with successful outcomes had shorter PICU stays (8.5 vs 13 d, P =.001) and hospital stays (17 vs 23 d, P =.03) stays. The NT needed to be changed for another interface in only 5 case patients, few complications (4 of 151 patients) were observed, and mortality (2 of 151 patients) was unrelated to NIV. CONCLUSIONS: Use of the NT showed 73% effectiveness, with few complications. The effectiveness was higher in e-NIV than i-NIV.
KW - Airway extubation
KW - Bronchiolitis
KW - Infant
KW - Noninvasive ventilation
KW - Pediatric intensive care units
KW - Respiratory insufficiency
UR - http://www.scopus.com/inward/record.url?scp=84898759314&partnerID=8YFLogxK
U2 - 10.4187/respcare.02556
DO - 10.4187/respcare.02556
M3 - Article
C2 - 23983270
AN - SCOPUS:84898759314
SN - 0020-1324
VL - 59
SP - 510
EP - 517
JO - Respiratory Care
JF - Respiratory Care
IS - 4
ER -