Increase in use of non-invasive ventilation for infants with severe bronchiolitis is associated with decline in intubation rates over a decade
Intensive Care Medicine,

Ganu SS et al. – Non–invasive ventilation (NIV) was successful in the vast majority of patients, particularly in those without risk factors and halved the length of stay (LOS) in intensive care. Failure of NIV was associated with increased duration of invasive ventilation and paediatric intensive care unit (PICU) LOS. A prospective study comparing different techniques of NIV will be helpful in defining the risks of failure of NIV.

Methods
  • Following ethics committee approval, the clinical database of a tertiary 23-bed paediatric intensive care unit (PICU) was reviewed for bronchiolitis admissions from January 2000 to December 2009.
  • Length of stay (LOS), ventilatory requirements and risk factors, including prematurity, respiratory syncytial virus (RSV) status, chronic lung, neuromuscular, immune and congenital heart disease, were analysed.

Results
  • Of 8,288 admissions, 520 (6.27 %) had bronchiolitis with 343 (65.9 %) having RSV.
  • Median (±SD)age and LOS were 2.78months and 2.68 (±4.32)days.
  • One (0.2 %) patient died.
  • Assisted ventilation was required for 399 (76.7 %) patients.
  • A total of 114 (28.6 %) patients were intubated directly and 285 (71.4 %) had a trial of non-invasive ventilation (NIV).
  • Significant increase in the use of NIV was seen (2.8 %/year) with decline in intubation rates (1.9 %/year) (p=0.002).
  • Of NIV patients, 237 (83.2 %) needed only NIV and 48 (16.8 %) failed and therefore needed intubation.
  • The median LOS was shorter in those who succeeded NIV (2.38±2.43days) compared to those with invasive ventilation (5.19±6.34days) and those who failed NIV (8.41±3.44days).
  • Presence of a risk factor increased the chances of failing NIV from 6 to 10 %.

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

    Currently, there are no available articles.

Your Unread Messages in Anesthesiology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Anesthesiology Articles

Indexed Journals in Anesthesiology: Anaesthesia, Anesthesia & Analgesia, Current Anaesthesia and Critical Caremore

Make smarter career moves with less time.

Sign up for our free job placement service today and have a dedicated career consultant help locate the right physician job for you!
Click Here for more information.

Get Started Now!

Free-of-charge, no obligation.

Terms and Conditions For M3 Career Consult

By registering with the M3 Career Consult service you authorize M3 USA Corporation to represent you in your job search. The following is a summary of the terms of our service and our mutual obligations to help you find a job:

  • You designate M3 to act as your agent and represent you in your job search;
  • You will not pay us for this service
  • You will advise us of any companies or positions to which you apply or have applied;
  • You will advise us if you believe you are not capable of performing a position for which we submit you, or for which you interview;
  • You will keep all information we provide you about companies or positions strictly confidential;
  • You will promptly provide us with information we request of you;
  • You will make yourself reasonably available for phone, video and in-person conversations and interviews;
  • You will be truthful in all of your communications with us; and
  • You will advise us if anything above changes.
 

The Top Read Articles of 2014 are Now Available

Scouring thousands of peer-reviewed journals and popular press, Our Editors just released the Top Read Articles of the Year. See the Top Read List