Non-Invasive Ventilation in a Pediatric Intensive Care Unit: An Experience of Tertiary Care Hospital Over 4 Years in Oman

Abstract

Background: Noninvasive ventilation (NIV) has now become an integral tool in the treatment of both acute and chronic respiratory failure, and at the same time reducing the need for invasive ventilation. Aim: To determinate the efficacy of NIV in pediatrics whom admitted to Pediatric intensive care unit (PICU) with respiratory failure (Short term evaluation). Subjects and Methods: Based on a retrospective review of electronic medical records (EPR) of patients who underwent NIV in the period between January 2007 and December 2010, demographic and clinical data were collected before and after applying the NIV. The data included heart rate (HR), respiratory rate (RR), oxygen concentration (PO2) and CO2 concentration (PCO2). Results: NIV was used for a total of 61 pediatric patients admitted to PICU during the period of the study. Pneumonia was the commonest indication for the NIV (n=25, 40.9%), and continuous positive airway pressure (CPAP) was used in 52(85.2%) patients. The mean duration of NIV was 8±7.2 days, there was a significant clinical improvement after one hour from application of NIV. The mean improvement in RR was from 48.4±2.2 to 35.0±1.5 (P=0.000), SPO2 was improved from 88.1±1.8 to 96.5±0.7 (P= 0.000), and the PCO2was improved from 61.4±6.1 to 48.7±3.7 (P=0.002). Five patients were failing to respond to the NIV and shifted to mechanical ventilation. Conclusion: The NIV is a useful tool for treatment of respiratory failure in pediatrics, especially under the age of one year. Pneumonia was the commonest indication for the use of the NIV.