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Observational Study
Is nasopharyngeal tube effective as interface to provide bilevel non-invasive ventilation?
- Eneritz Velasco Arnaiz, Francisco José Cambra Lasaosa, Lluïsa Hernández Platero, Núria Millán García Del Real, and Martí Pons-Òdena.
- Pediatric Intensive Care Unit, Hospital Universitario Sant Joan de Déu, Barcelona, Spain.
- Respir Care. 2014 Apr 1;59(4):510-7.
BackgroundThe nasopharyngeal tube (NT) is a potential interface for noninvasive ventilation (NIV) available in all health care centers. The aim of the study was to describe our experience in the use of the NT for bi-level NIV in infants and its effectiveness.MethodsProspective observational study from January 2007 to December 2010, including all patients ≤ 6 months old admitted to the pediatric ICU (PICU) and treated with NIV with two levels of pressure using the NT. Clinical data collected before starting NIV, and at 2, 8, 12 and 24 h, were analyzed following NIV initiation: first-line or initial NIV (i-NIV), elective postextubation NIV (e-NIV), and rescue postextubation NIV (r-NIV). The need for intubation was considered to be NIV failure.ResultsOne hundred fifty-one episodes of NIV were included in the study, with 65% of patients having bronchiolitis. e-NIV was most frequently used (48%) (i-NIV 44%, r-NIV 8%), and the failure rate, 27% in total, was highest in the i-NIV group (37%) (e-NIV 18%, r-NIV 25%). Case patients with successful outcomes had shorter PICU stays (8.5 vs. 13 d, P = .001) and hospital stays (17 vs. 23 d, P = .03) stays. The NT needed to be changed for another interface in only 5 case patients, few complications (4 of 151 patients) were observed, and mortality (2 of 151 patients) was unrelated to NIV.ConclusionsUse of the NT showed 73% effectiveness, with few complications. The effectiveness was higher in e-NIV than i-NIV.
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