Infants with severe respiratory syncytial virus needed less ventilator time with nasal continuous airways pressure then invasive mechanical ventilation

Ilse Borckink, Sandrine Essouri, Marie Laurent, Marcel J. I. J. Albers, Johannes G. M. Burgerhof, Pierre Tissieres, Martin C. J. Kneyber*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

19 Citations (Scopus)

Abstract

AIM: Nasal continuous positive airway pressure (NCPAP) has been proposed as an early first-line support for infants with severe respiratory syncytial virus (RSV) infection. We hypothesised that infants <6 months with severe RSV would require shorter ventilator support on NCPAP than invasive mechanical ventilation (IMV).

METHODS: Retrospective cohort analysis of infants admitted to two paediatric intensive care units, one primarily using NCPAP and one exclusively using IMV, between January 2008 and February 2010.

RESULTS: We studied 133 (NCPAP n = 89, IMV n = 46) consecutively admitted infants. On admission, disease severity [i.e. Paediatric RISk of Mortality (PRISM) II score (NCPAP 5.1 ± 2.8 vs. IMV 12.2 ± 6.0, p < 0.001) and SpO2 /Fi O2 ratio (NCPAP 309 ± 81 vs. IMV 135 ± 98, p < 0.001)] was higher in the IMV group. NCPAP remained independently associated with shorter ventilatory support (hazard ratio 2.3, 95% CI 1.1-4.7, p = 0.022) after adjusting for PRISM II score, PCO2 , SpO2 /Fi O2 ratio, bronchopulmonary dysplasia and occurrence of clinically suspected secondary bacterial pneumonia.

CONCLUSION: Nasal continuous positive airway pressure was independently associated with a shorter duration of ventilatory support. Differences in baseline disease severity mandate a randomised trial before the routine use of NCPAP can be recommended.

Original languageEnglish
Pages (from-to)81-85
Number of pages5
JournalActa Paediatrica
Volume103
Issue number1
DOIs
Publication statusPublished - Jan-2014

Keywords

  • Respiratory syncytial virus
  • Bronchiolitis
  • Noninvasive ventilation
  • Mechanical ventilation
  • Nasal continuous positive airway pressure
  • SEVERE VIRAL BRONCHIOLITIS
  • PEDIATRIC INTENSIVE-CARE
  • NONINVASIVE VENTILATION
  • INFECTION
  • CHILDREN
  • THERAPY
  • TRIAL
  • CPAP
  • UNIT

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