Noninvasive ventilation for Pediatric Acute Respiratory Distress Syndrome: experience from the 2016/2017 Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology Prospective Cohort Study

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dc.contributor.authorDíaz, Franco
dc.contributor.authorEmeriaud, Guillaume
dc.contributor.authorPons-Òdena, Marti
dc.contributor.authorBhalla, Anoopindar K.
dc.contributor.authorShein, Steven L.
dc.contributor.authorKillien, Elizabeth Y.
dc.contributor.authorModesto i Alapont, Vicent
dc.contributor.authorRowan, Courtney
dc.contributor.authorBaudin, Florent
dc.contributor.authorLin, John C.
dc.contributor.authorGrégoire, Gabrielle
dc.contributor.authorNapolitano, Natalie
dc.contributor.authorMayordomo-Colunga, Juan
dc.contributor.authorCruces, Pablo
dc.contributor.authorMedina, Alberto
dc.contributor.authorSmith, Lincoln
dc.contributor.authorKhemani, Robinder G.
dc.date.accessioned2024-07-09T14:21:48Z
dc.date.available2024-07-09T14:21:48Z
dc.date.issued2023
dc.description.abstractObjectives: The worldwide practice and impact of noninvasive ventilation (NIV) in pediatric acute respiratory distress syndrome (PARDS) is unknown. We sought to describe NIV use and associated clinical outcomes in PARDS. Design: Planned ancillary study to the 2016/2017 prospective Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology study. Setting: One hundred five international PICUs. Patients: Patients with newly diagnosed PARDS admitted during 10 study weeks. Interventions: None. Measurements and main results: Children were categorized by their respiratory support at PARDS diagnosis into NIV or invasive mechanical ventilation (IMV) groups. Of 708 subjects with PARDS, 160 patients (23%) received NIV at PARDS diagnosis (NIV group). NIV failure rate (defined as tracheal intubation or death) was 84 of 160 patients (53%). Higher nonrespiratory pediatric logistic organ dysfunction (PELOD-2) score, Pa o2 /F io2 was less than 100 at PARDS diagnosis, immunosuppression, and male sex were independently associated with NIV failure. NIV failure was 100% among patients with nonrespiratory PELOD-2 score greater than 2, Pa o2 /F io2 less than 100, and immunosuppression all present. Among patients with Pa o2 /F io2 greater than 100, children in the NIV group had shorter total duration of NIV and IMV, than the IMV at initial diagnosis group. We failed to identify associations between NIV use and PICU survival in a multivariable Cox regression analysis (hazard ratio 1.04 [95% CI, 0.61-1.80]) or mortality in a propensity score matched analysis ( p = 0.369). Conclusions: Use of NIV at PARDS diagnosis was associated with shorter exposure to IMV in children with mild to moderate hypoxemia. Even though risk of NIV failure was high in some children, we failed to identify greater hazard of mortality in these patients
dc.identifier.citationPediatric Critical Care Medicine, Vol. 24, N° 9 (2023) p. 715-726
dc.identifier.doi10.1097/PCC.0000000000003281
dc.identifier.issn1529-7535
dc.identifier.issne1947-3893
dc.identifier.orcidhttps://orcid.org/0000-0003-4763-074Xes
dc.identifier.urihttp://hdl.handle.net/20.500.12254/3771
dc.language.isoen
dc.publisherThe Society of Critical Care Medicine; The World Federation of Pediatric Intensive and Critical Care Societies
dc.rightsAtribución-NoComercial-CompartirIgual 3.0 Chile (CC BY-NC-SA 3.0 CL)
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/cl/
dc.subjectPARDSes
dc.subjectBIPAPes
dc.subjectPediatrics
dc.subjectMechanical ventilation
dc.subjectSíndrome de dificultad respiratoria
dc.subject.otherPARDSes
dc.subject.otherMechanical Ventilationes
dc.subject.otherpediatricses
dc.titleNoninvasive ventilation for Pediatric Acute Respiratory Distress Syndrome: experience from the 2016/2017 Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology Prospective Cohort Study
dc.typeArtículoes
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