Non-invasive Ventilation in Pediatric Patients with Acute Respiratory Failure

A. López
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Abstract

Academic and clinical interest in noninvasive ventilation (NIV) for the treatment of acute respiratory failure (ARF) is high (Figure 1). The NIV isn’t often used. The evidence overwhelmingly favors its usage in those who are experiencing COPD (chronic obstructive pulmonary disease) exacerbations and people who have acute cardiogenic pulmonary edema. Acute and chronic respiratory illnesses were the cause of 8% of child fatalities, 20% of weekly GP visits, and 15% of hospital admissions in the UK in 2001 [1]. Increased proof of efficacy, advancements in ventilator technology, and pediatric user interface design, as well as public and physician awareness, are all potential contributing factors. Numerous of these kids were raised at home [2, 3]. When used in conjunction with ventilatory support, pediatric intensive care unit (PICU) admissions can be decreased [4] and hospital release following ventilatory decompensation can be facilitated [5]. Even though many instances are benign and self-limited, some individuals need more advanced respiratory care. In many situations of ARF, invasive mechanical ventilation (IMV) is a crucial strategy; yet endotracheal intubation (ETI) has obvious dangers [6].
急性呼吸衰竭患儿的无创通气
无创通气(NIV)用于治疗急性呼吸衰竭(ARF)的学术和临床兴趣很高(图1)。无创通气并不经常使用。证据压倒性地支持在慢性阻塞性肺疾病(COPD)恶化和急性心源性肺水肿患者中使用。2001年,急性和慢性呼吸系统疾病是英国8%的儿童死亡、20%的每周全科医生就诊和15%的住院的原因[1]。疗效证据的增加、呼吸机技术的进步、儿科用户界面设计以及公众和医生的意识都是潜在的促成因素。这些孩子中有许多是在家里长大的[2,3]。当与呼吸支持联合使用时,可减少儿科重症监护病房(PICU)入院率[4],并可促进呼吸失代偿后的出院[5]。尽管许多病例是良性的和自限性的,但有些人需要更高级的呼吸护理。在许多ARF情况下,有创机械通气(IMV)是一种至关重要的策略;但气管插管(ETI)存在明显的危险[6]。
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