Premium
Non‐invasive ventilation practices in children across Europe
Author(s) -
MayordomoColunga Juan,
PonsÒdena Martí,
Medina Alberto,
Rey Corsino,
Milesi Christophe,
Kallio Merja,
Wolfler Andrea,
GarcíaCuscó Mireia,
Demirkol Demet,
GarcíaLópez Milagros,
Rimensberger Peter
Publication year - 2018
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23988
Subject(s) - medicine , intensive care , bronchiolitis , ventilation (architecture) , respiratory distress , intubation , bronchospasm , intensive care medicine , emergency medicine , asthma , anesthesia , respiratory system , mechanical engineering , engineering
Abstract Objectives To describe the diversity in practice in non‐invasive ventilation (NIV) in European pediatric intensive care units (PICUs). Working hypothesis No information about the use of NIV in Pediatrics across Europe is currently available, and there might be a wide variability regarding the approach. Study design Cross‐sectional electronic survey. Methodology The survey was distributed to the ESPNIC mailing list and to researchers in different European centers. Results One hundred one units from 23 countries participated. All respondent units used NIV. Almost all PICUs considered NIV as initial respiratory support (99.1%), after extubation (95.5% prophylactically, 99.1% therapeutically), and 77.5% as part of palliative care. Overall NIV use outside the PICUs was 15.5% on the ward, 20% in the emergency department, and 36.4% during transport. Regarding respiratory failure cause, NIV was delivered in pneumonia (97.3%), bronchiolitis (94.6%), bronchospasm (75.2%), acute pulmonary edema (84.1%), upper airway obstruction (76.1%), and in acute respiratory distress syndrome (91% if mild, 53.1% if moderate, and 5.3% if severe). NIV use in asthma was less frequent in Northern European units in comparison to Central and Southern European PICUs ( P = 0.007). Only 47.7% of the participants had a written protocol about NIV use. Bilevel NIV was applied mostly through an oronasal mask (44.4%), and continuous positive airway pressure through nasal cannulae (39.8%). If bilevel NIV was required, 62.3% reported choosing pressure support (vs assisted pressure‐controlled ventilation) in infants; and 74.5% in older children. Conclusions The present study shows that NIV is a widespread technique in European PICUs. Practice across Europe is variable.