机构:[1]Capital Med Univ, Beijing Childrens Hosp, Pediat Intens Care Unit, Beijing, Peoples R China;临床科室重症医学科首都医科大学附属北京儿童医院[2]KK Womens & Childrens Hosp, Dept Paediat Subspecialties, Childrens Intens Care Unit, Singapore, Singapore;[3]Natl Univ Singapore Hosp, Khoo Teck Puat Natl Univ Childrens Med Inst, Dept Paediat, Paediat Intens Care Unit, Singapore, Singapore;[4]Univ Malaya, Dept Paediat, Paediat Intens Care Unit, Kuala Lumpur, Malaysia;[5]Mahidol Univ, Dept Pediat, Div Pediat Crit Care, Bangkok, Thailand;[6]Sarawak Gen Hosp, Dept Paediat, Kuching, Malaysia;[7]King Chulalongkorn Mem Hosp, Dept Pediat, Div Pediat Crit Care, Bangkok, Thailand;[8]Natl Childrens Hosp, Pediat Intens Care Unit, Hanoi, Vietnam;[9]Mahidol Univ, Siriraj Hosp, Fac Med, Dept Pediat, Bangkok, Thailand;[10]Chongqing Med Univ, Childrens Hosp, Pediat Intens Care, Chongqing, Peoples R China;[11]Duke NUS Med Sch, Ctr Quantitat Med, Singapore, Singapore;[12]KK Womens & Childrens Hosp, Childrens Intens Care Unit, 100 Bukit Timah Rd, Singapore 229899, Singapore
Introduction: Evidence supporting non-invasive ventilation (NIV) in paediatric acute respiratory distress syndrome (PARDS) remains sparse. We aimed to describe characteristics of patients with PARDS supported with NIV and risk factors for NIV failure. Materials and Methods: This is a multicentre retrospective study. Only patients supported on NIV with PARDS were included. Data on epidemiology and clinical outcomes were collected. Primary outcome was NIV failure which was defined as escalation to invasive mechanical ventilation within the first 7 days of PARDS. Patients in the NIV success and failure groups were compared. Results: There were 303 patients with PARDS; 53/303 (17.5%) patients were supported with NIV. The median age was 50.7 (interquartile range: 15.7-111.9) months. The Paediatric Logistic Organ Dysfunction score and oxygen saturation/fraction of inspired oxygen (SF) ratio were 2.0 (1.0-10.0) and 155.0 (119.4-187.3), respectively. Indications for NIV use were increased work of breathing (26/53 [49.1%]) and hypoxia (22/53 [41.5%]). Overall NIV failure rate was 77.4% (41/53). All patients with sepsis who developed PARDS experienced NIV failure. NIV failure was associated with an increased median paediatric intensive care unit stay (15.0 [9.5-26.5] vs 4.5 [3.0-6.8] days; P<0.001) and hospital length of stay (26.0 [17.0-39.0] days vs 10.5 [5.5-22.3] days; P= 0.004). Overall mortality rate was 32.1% (17/53). Conclusion: The use of NIV in children with PARDS was associated with high failure rate. As such, future studies should examine the optimal selection criteria for NIV use in these children.
基金:
Khoo Pilot Research Award from the Estate of Tan Sri Khoo Teck Puat [Duke-NUS-KPA/2016/0024]
第一作者机构:[1]Capital Med Univ, Beijing Childrens Hosp, Pediat Intens Care Unit, Beijing, Peoples R China;
通讯作者:
通讯机构:[2]KK Womens & Childrens Hosp, Dept Paediat Subspecialties, Childrens Intens Care Unit, Singapore, Singapore;[12]KK Womens & Childrens Hosp, Childrens Intens Care Unit, 100 Bukit Timah Rd, Singapore 229899, Singapore
推荐引用方式(GB/T 7714):
Zeng Jian Sheng,Qian Su Yun,Wong Judith J. M.,et al.Non-Invasive Ventilation in Children with Paediatric Acute Respiratory Distress Syndrome[J].ANNALS ACADEMY OF MEDICINE SINGAPORE.2019,48(7):224-232.
APA:
Zeng, Jian Sheng,Qian, Su Yun,Wong, Judith J. M.,Ong, Jacqueline S. M.,Gan, Chin Seng...&Lee, Jan Hau.(2019).Non-Invasive Ventilation in Children with Paediatric Acute Respiratory Distress Syndrome.ANNALS ACADEMY OF MEDICINE SINGAPORE,48,(7)
MLA:
Zeng, Jian Sheng,et al."Non-Invasive Ventilation in Children with Paediatric Acute Respiratory Distress Syndrome".ANNALS ACADEMY OF MEDICINE SINGAPORE 48..7(2019):224-232