ABSTRACT 433

Abstract

Background and aims: Sparse data available on the use ofnoninvasive ventilation (NIV) in infants and children.Clinical application of high flow nasal cannula therapy(HFNC) in young children has been increased in the recent years. Aims: To analyse the clinical profile of critically ill children receiving NIV and their outcome. Methods: Retrospective review of all children managed with NIV over 3 years in PICU. Data of children who received HFNC therapy over a period of one year was analyzed. Results: A total of 419 children were managed with NIV. Females formed the majority (60%). 24 neonates and 101 infants. 333 (80%) were managed with Nasopharyngeal (NPCPAP); 86 (20%) with mask NIV. Common primary diagnoses include respiratory failure due to Pneumonia, CHD, Sepsis and bronchiolitis. In 44 (11%) children, NIV was used as a modality to wean from invasive or for post extubation stridor. Primary outcome was failed NIV which lead to intubation. Totally, 49 (12%) children failed NIV; of which 36 were on NPCPAP. 51 (12%) children died or taken in a terminally ill state. HFNC used in 381 children over one year. Majority (273; 72%) of them were young infants (1-24months). There were 31 (8%) newborn. Common diagnoses include respiratory distress due to pneumonia (83;22%), Sepsis(60;16%), Dengue (38;10%), Post surgical (37;10%), CHD (34;9%), bronchiolitis (31;8%) and others (88;25%). Of the total 381, 42 (11%) failed HFNC and 34 children needed intubation. Conclusions: NIV is a feasible stratergy to avoid intubation if used appropriately and early during the respiratory distress. In our cohort, only 12% failed NIV and 11% high flow therapy.