Noninvasive positive pressure ventilation for acute respiratory failure in children: a concise review

Najaf-Zadeh, Abolfazl; Leclerc, Francis

doi:10.1186/2110-5820-1-15

Annals of Intensive Care

Table 1 NPPV in pediatric ARF from different causes

From: Noninvasive positive pressure ventilation for acute respiratory failure in children: a concise review

Study	Cause of ARF (n)	Location, Patients (n)	Age (yr)	NPPV type, Interface	Avoided ETI (%)	Other reported outcomes
ARF due to acute airway obstruction
Beers et al. [10] retrospective	Status asthmaticus	ED, 73	2-17^a	BiPAP Nasal mask	97	Improved RR, SaO₂ Avoided PICU admission: 22% Major complication: 0%
Carroll et al. [11] retrospective	Status asthmaticus	PICU, 5	9.6^b	BiPAP Nasal mask	100	Improved RR, MPIS Major complication: 0%
Needleman et al. [12] prospective, physiological	Status asthmaticus	PICU, 15	8-21^a	BiPAP Nasal mask	-	Improved RR, thoracoabdominal synchrony, fractional inspired time: 80%
Akingbola et al. [13] case reports	Status asthmaticus	PICU, 3	9-15^a	BIPAP Nasal mask	100	Improved RR, PaCO₂, pH Major complication: 0%
Till et al. [14] prospective, randomized, crossover	Acute lower airway obstruction	PICU, 16	4 (0.2-14)^a,c	BiPAP Nasal or facial mask	-	Improved RR, CAS, O₂ requirement Major complication: 0%
Yanez et al. [15] multicentric, prospective, randomized, controlled (NPPV subgroup)	Bronchiolitis- pneumonia (18), asthma (4), pneumonia (3)	PICU, 25	1.3 (0.1-13)^a,c	BIPAP, BiPAP Facial mask	72	Improved RR, HR, PaO₂/FiO₂ at 1 hr Major complication: 4% (interstitial emphysema)
Thia et al. [16] ^d prospective, randomized, crossover	Bronchiolitis	PICU, 29	0.2 (0.1-0.4)^c,e	CPAP Nasal prongs	-	Improved PaCO₂ Major complication: 0%
Cambonie et al. [17] ^d prospective, physiological	Bronchiolitis	PICU, 12	0.1^b	CPAP Nasal mask	100	Improved HR, P_tcCO₂ , O₂ requirement, respiratory distress score, MABP at 1 hr Major complication: 0%
Javouhey et al. [18]^d retrospective (NPPV subgroup)	Bronchiolitis	PICU, 15	0.1^c	BiPAP, CPAP Nasal mask	67	Major complication: 7% (bacterial pulmonary coinfections)
Larrar et al. [19] ^d prospective, noncontrolled (NPPV subgroup)	Bronchiolitis	PICU, 53	0.1 (0.01-1)^a,b	CPAP Nasal prongs	75	Improved RR, PaCO₂ at 2 hrs Death: 0% Major complication: 0%
Campion et al. [20] ^d,f prospective, noncontrolled (NPPV subgroup)	Bronchiolitis-pneumonia	PICU, 69	0.1 (0.03-1)^a,c	BIPAP, CPAP Nasal prongs, facial mask	83	Improved PaCO₂, pH at 2 hrs Death: 0% Major complication: 0%
Essouri et al. [21] prospective, randomized, controlled	Laryngomalacia (5), tracheomalacia (3), others (2)	PICU, 10	0.8 (0.2-1.5)^a,c	BiPAP, CPAP Nasal mask	-	Improved RR, respiratory effort in both types of NPPV Patient-ventilator asynchrony with BiPAP
Padman et al. [22] ^f prospective, noncontrolled (upper airway obstruction subgroup)	Inspiratory stridor	PICU, 3	13^b	BiPAP Nasal mask	100	Improved RR, HR, gas exchange, serum HCO₃, dyspnea score at 72 hrs Major complication: 0%
ARF due to parenchymal lung disease
Munoz-Bonet et al. [23]]^f prospective, noncontrolled (pneumonia subgroup)	Pneumonia	PICU, 13	0.2-15.8^a	BIPAP Facial mask	100	Improved RR, HR, PaCO₂, SaO₂, pH, clinical score within the first 6 hrs Death: 0% Major complication: 0%
Bernet et al. [24] ^d prospective, noncontrolled (pneumonia subgroup)	Pneumonia	PICU, 14	2.4 (0.01-18)^g	BIPAP, CPAP Nasal or facial mask	50	Improved RR, HR, PaCO₂, serum HCO₃ within the first 8 hrs Death: 0%
Fortenberry et al. [25] ^f retrospective, (pneumonia subgroup)	Pneumonia	PICU, 21	0.7-17^a	BiPAP Nasal mask	90	Improved RR, PaCO₂, PaO₂, pH, SaO₂, PaO₂/FiO₂ at 1 hr Death: 5% Major complication: 0%
Joshi et al. [26] retrospective (primary parenchymal lung disease subgroup)	Pneumonia, ARDS	PICU, 29	13^c	BiPAP Facial mask	62	Improved RR, PaCO₂, O₂ requirement Major complication: 0%
Essouri et al. [27] retrospective (primary parenchymal lung disease subgroup)	CAP (23), ARDS (9), ACS (9)	PICU, 41	8 (0.2-16)^a,b	BIPAP Nasal or facial mask	87 (CAP) 22 (ARDS) 100 (ACS)	Improved RR, PaCO₂ at 2 hr Death: 4% (CAP), 22% (ARDS), 0% (ACS) Major complication: 0%
Padman et al. [22] ^f prospective, noncontrolled (primary parenchymal lung disease subgroup)	Pneumonia (13), ACS (5 episodes)	PICU, 17	10.6^b	BiPAP Nasal mask	85 (CAP) 80 (ACS)	Improved RR, HR, gas exchange, serum HCO₃, dyspnea score at 72 hrs Major complication: 0%
Padman et al. [28] retrospective	ACS (25 episodes)	Inpatient ward, 9	11.8 (4-20)^a,b	BiPAP Nasal mask	100	Improved RR, HR, SaO₂, O₂ requirement Avoided PICU admission: 44%

ACS, acute chest syndrome; ARDS, acute respiratory distress syndrome; ARF, acute respiratory failure; BiPAP, bilevel positive airway pressure; BIPAP, biphasic positive airway pressure; CAS, clinical asthma score; CAP, community-acquired pneumonia; CPAP, continuous positive airway pressure; ED, emergency department; ETI, endotracheal intubation; FiO₂, fraction of oxygen in inspired gas; HR, heart rate; MABP, mean arterial blood pressure; MPIS, modified pulmonary index score; NPPV, noninvasive positive pressure ventilation; PICU, pediatric intensive care unit; PaCO₂, arterial partial pressure of carbon dioxide; PaO₂, arterial partial pressure of oxygen; P_tcCO₂, transcutaneous PCO₂; RR, respiratory rate; SaO₂, arterial oxygen saturation.
^aRange.
^bMean.
^cMedian.
^dNeonatal cases also were included in the study.
^eInterquartile range.
^fCertain patients included in the study had underlying neurologic or chronic lung disease.
^gThe numbers represent the median (range) age of the patients (n = 42) with ARF of various causes included in the study.

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