Use of elective non-invasive ventilation in a Pediatric Intensive Care Unit
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Abstract
Elective non-invasive ventilation (eNIV) is an alternative to avoid intubation and invasive mechanical ventilation (IMV) in the treatment of acute respiratory failure in infants and children, reducing morbidity and mortality and hospitalization days.
Objective: To know the success rate of using eNIV in patients admitted to a pediatric intensive care unit (PICU) and explore factors associated with success.
Design: Descriptive, observational and retrospective.
Methods: Data from patients who entered eVNI between 2021 and 2023 were collected from the pediatric kinesiology team database and corroborated with the digital medical records of each patient. Age, sex, Pediatric Mortality Index 3 (PIM 3), diagnosis, comorbidities, days of eNIV, SpO2/FIO2 onset index (SaFiO2), causes of eNIV failure, and days of hospitalization were collected. Successful eNIV was considered when there was no need for intubation.
Results: Of the 780 patients admitted to the PICU between January 2021 and August 2023, 159 required eNIV. The success rate was 71.1%. Initial SaFiO2 was identified in a statistically significant and independent manner with the success of eNIV. The eNIV success group remained hospitalized for 7 days (IQR 6-9), while the failure group remained hospitalized for 14.5 days (IQR 11-21) (p<0.001).
Conclusion: Successful eNIV prevented a high percentage of patients from being admitted to intubation and IMV. Initial SaFiO2 was found to be a significant and independent variable with the success of eNIV
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