Abstract P-615: POST-EXTUBATION USE OF NON-INVASIVE VENTILATION IN CHILDREN- A RANDOMIZED CONTROLLED TRIAL

Abstract

Aims & Objectives: The present investigation was to study the effect of elective use NIV on reintubation, length of stay (LOS) in PICU and hospital and mortality after extubation. Methods Over 12 months all patients on invasive mechanical ventilation (IMV) for >48 hrs were enrolled after successful weaning. Patients were randomized immediately before extubation to receive NIV or O2 therapy. All cases were monitored for increased work of breathing and blood gases were obtained at 2, 6 and 24 hours post extubation. Results 97 patients were randomized, 46 received NIV (BIPAP mode, Drager Evita) and 51 received O2 by simple mask. SpO2 was maintained>92%. The primary disease, PRISM scores at 12 (8.4 ± 7.2 vs 8.9 ± 6.9, p value 0.6) and 24 (9.3 ± 8 vs 8.8 ± 7, p value 0.9) hrs and duration of MV prior to extubation (4.5 ± 3.7 vs 4.3 ± 3.4 days, p value 0.7) were not significantly different in two study groups. Out of 97 patients, 19 (19.7%) patients were re-intubated within 48 hours of extubation, 13(25%) patients belonged to O2 group and 6(13%) were in NIV group (p value- 0.12). The post extubation durations of PICU (4.18 ± 2.9 vs 3.67 ± 2.5 days, p value 0.4) and hospital stay (18 ± 9 vs 17.2 ± 12.3 days, p value 0.3) were not significantly different in two study groups. There were two deaths, one in each study group. Conclusions NIV did not show benefits over oxygen therapy in immediate post extubation state in children.