Abstract
The initiation of non-invasive mechanical ventilation (NIV) and when invasive mechanical ventilation must start is still an unsolved dilemma in the paediatric literature. There are no specific or absolute criteria that can predict the onset of successful NIV in a patient with acute respiratory failure. The aim of this study was to determine the prognostic factors for NIV failure in critically ill patients in the paediatric intensive care unit. Material and methodsA retrospective analytical observational cross-sectional study was conducted in 2 paediatric intensive care units over a 2 year period (January 2014 to January 2016). It included all patients admitted to the paediatric intensive care units and required ventilatory support for risk of respiratory failure, and invasive mechanical ventilation extubated patients at risk of extubation failure were recruited. ResultsThere was a 70.2% success out of a total of 252 patients on NIV, the majority being those with respiratory diseases. Predictors of failure in the use of NIV included having a pCO2>35mmHg (OR: 3.66 [95% CI: 1.99-6.72), a pO2<60mmHg (OR: 1.69 [95% CI: 0.95-2.98]), and a Paediatric Mortality Risk Score on admission to a PICU (PRISM II)>10 (OR: 10.3 [95% CI: 5.23-20.27]; P<.05), were predictors of failure in the use of NIV. ConclusionThe use of early VNI decreased the need for endotracheal intubation in more than 70% in the patients in this study.
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