What are the current indications for noninvasive ventilation in children?

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose of review: The aims of this paper are to examine the physiological rationale for noninvasive respiratory support (NRS) in children older than 1 month with acute respiratory failure, to review clinical available data and to give some practical recommendations for the safe application of NRS. Recent findings: NRS is the delivery of ventilatory support without the need for an invasive airway. Two types of NRS are commonly used in the pediatric population: noninvasive continuous positive airway pressure and noninvasive positive pressure ventilation. In general, the evidence to support the use of NRS in children with acute respiratory failure is scarce. However, two randomized studies have been recently published suggesting that noninvasive positive pressure ventilation ameliorates clinical signs and gas exchange while reducing the need for endotracheal intubation. Moreover, noninvasive continuous positive airway pressure and heliox may improve clinical scores and carbon dioxide washout in infants with severe bronchiolitis, without major complications. Data from noncontrolled studies show that NRS unloads the respiratory muscles and that the helmet can be a valid alternative to a facial and/or nasal mask when noninvasive continuous positive airway pressure is administered to children in the early stage of acute respiratory failure. Summary: Preliminary clinical data show that NRS is safe and effective in children with acute respiratory failure.

Original languageEnglish
Pages (from-to)368-374
Number of pages7
JournalCurrent Opinion in Anaesthesiology
Volume23
Issue number3
DOIs
Publication statusPublished - Jun 2010

Keywords

  • Acute respiratory failure
  • Children
  • Infants
  • Mechanical ventilation
  • Noninvasive ventilation

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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