Document Detail


U.S. attitudes and perceived practice for noninvasive ventilation in pediatric acute respiratory failure.
MedLine Citation:
PMID:  20921916     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: : Few pediatric studies exist regarding the use of noninvasive positive-pressure ventilation for acute respiratory failure; however, those that do suggest a role. This study seeks to describe attitudes and perceived practices of pediatric intensivists regarding the use of noninvasive positive-pressure ventilation in children with acute respiratory failure.
DESIGN: : Electronic survey.
SETTING: : Medical institutions.
PARTICIPANTS: : Of the 932 physicians approached, 353 (38%) responded to the survey. Respondents included U.S. physicians practicing pediatric critical care (90%), pediatric anesthesia critical care (4%), pediatric pulmonary critical care (4%), and other disciplines (2%).
INTERVENTIONS: : Survey.
MEASUREMENTS AND MAIN RESULTS: : The survey contained questions regarding 1) practitioner demographics, 2) patient characteristics, and 3) clinical cases designed to assess noninvasive positive-pressure ventilation use in certain patient scenarios. Noninvasive positive-pressure ventilation was used by 99% of the respondents, with 60% using noninvasive positive-pressure ventilation as initial support >10% of the time. Respondents reported use of noninvasive positive-pressure ventilation for acute respiratory failure in lower airway disease (70%), asthma (51%), acute lung injury/acute respiratory distress syndrome (43%), and upper airway obstruction (31%). In clinical scenarios, respondents reported that the factors associated with nonuse of noninvasive positive-pressure ventilation as initial support were disease process (31%), oxygenation (19%), ventilation severity (15%), expectation that the patient was likely to worsen (12%), and age or inability to cooperate (11%).
CONCLUSIONS: : Noninvasive positive-pressure ventilation is widely used and most frequently utilized in patients with acute lower airway disease. Factors such as severe defects in oxygenation and ventilation, disease progression, and patient tolerability decreased the likelihood of use. These findings may help direct further studies of noninvasive positive-pressure ventilation in children with acute respiratory failure.
Authors:
Jeffrey J Fanning; K Jane Lee; Dawn S Bragg; Rainer G Gedeit
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  12     ISSN:  1529-7535     ISO Abbreviation:  Pediatr Crit Care Med     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e187-94     Citation Subset:  IM    
Affiliation:
From the Pediatric Acute Care Associates of North Texas (JJF), Dallas, TX; Pediatric Critical Care Medicine (JJF), Medical City Children's Hospital, Dallas, TX; Department of Pediatrics (KJL, DSB, RGG), Medical College of Wisconsin, Milwaukee, WI; Division of Critical Care Medicine (KJL, RGG), Children's Hospital of Wisconsin, Milwaukee, WI.
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