A multicentered study on efficiency of noninvasive ventilation procedures (SAFE-NIV)

Background/aim: To characterize the clinical course of noninvasive positive pressure ventilation (NIPPV) and high flow humidified nasal cannula ventilation (HFNC) procedures; perform risk analysis for ventilation failure. Material and methods: This prospective, multi-centered, observational study was conducted in 352 PICU admissions (1 month-18 years) between 2016 and 2017. SPSS-22 was used to assess clinical data, define thresholds for ventilation parameters and perform risk analysis. Results: Patient age, onset of disease, previous intubation and hypoxia influenced the choice of therapy mode: NIPPV was preferred in older children (p = 0.002) with longer intubation (p < 0.001), ARDS (p = 0.001), lower respiratory tract infections (p < 0.001), chronic respiratory disease, (p = 0.005), malignancy (p = 0.048) and immune deficiency (p = 0.026). The failure rate was 13.4%. sepsis, ARDS, prolonged intubation, and use of nasal masks were associated with NIV failure (p = 0.001, p < 0.001, p < 0.001, p = 0.025). The call of intubation or re-intubation was given due to respiratory failure in twenty-seven (57.5%), hemodynamic instability in eight (17%), bulbar dysfunction or aspiration in 5 (10.6%), neurological deterioration in 4 (8.5%) and developing ARDS in 3 (6.4%) children. A reduction of less than 10% in the respiration within an hour increased the odds of failure by 9.841 times (OR: 9.841, 95% CI: 2.0021–48.3742). FiO2 > 55% at 6th hours and PRISM-3 >8 were other failure predictors. Of the 9.9% complication rate, the most common complication was pressure ulcerations (4.8%) and mainly observed when using full-face masks (p = 0.047). Fifteen (4.3%) patients died of miscellaneous causes. Tracheostomy cannulation was performed on 16 children due to prolonged mechanical ventilation (8% in NIPPV, 2.6% in HFNC) Conclusion: Absence of reduction in the respiration rate within an hour, FiO2requirement >55% at 6th hours and PRISM-3 score >8 predict NIV failure.Key words: HFNC, noninvasive positive pressure ventilation, children, respiratory failure

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Alpgiray B (2006) Determination of the effects of the canola oil on the performance and emission characteristics of the diesel engine. Master Thesis. Ankara University, Institute of Natural and Applied Sciences. 1. Wing R, Armsby CC. Non-invasive ventilation in pediatric acute respiratory illness. Clinical Pediatric Emergency Medicine 2015; 16 (3): 154-161. doi: 10.1016/j.cpem.2015.07.004
2. Keenan SP, Sinuff T, Burns KEA, Muscedere J, Kutsogiannis J et al. Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting. Canadian Medical Association Journal 2011; 183 (3): 195-214. doi: 10.1503/cmaj.100071
3. Fioretto JR, Ribeiro CF, Carpi MF, Bonatto RC, Moraes MA et al. Comparison between noninvasive mechanical ventilation and standard oxygen therapy in children up to 3 years old with respiratory failure after extubation: a pilot prospective randomized clinical study. Pediatric Critical Care Medicine 2015; 16 (2): 124-130. doi: 10.1097/PCC.0000000000000309
4. Fedor KL. Noninvasive respiratory support in infants and children. Respiratory Care 2017; 62 (6): 699-717. doi: 10.4187/ respcare.05244
5. Munoz-Bonet JI, Flor-Macian EM, Brines J, Roselló-Millet PM, Cruz Llopis M et al. Predictive factors for the outcome of noninvasive ventilation in pediatric acute respiratory failure. Pediatric Critical Care Medicine 2010; 11 (6): 675-680. doi: 10.1097/PCC.0b013e3181d8e303
6. Essouri S, Laurent M, Chevret L, Durand P, Ecochard E et al. Improved clinical and economic outcomes in severe bronchiolitis with pre-emptive nCPAP ventilatory strategy. Intensive Care Medicine 2014; 40 (1): 84-91. doi: 10.1007/ s00134-013-3129-z
7. Mayordomo-Colunga J, Medina A, Rey C, Menéndez S, Arcos ML et al. Non-invasive ventilation in pediatric status asthmaticus: a prospective observational study. Pediatric Pulmonology 2011; 46 (10): 949-955. doi: 10.1002/ppul.21466
8. Bonora JP, Frydman J, Retta A, Canepari A. Post-extubation non-invasive ventilation in the pediatric intensive care unit: a multicenter study. Archivos argentinos de pediatria 2018; 116 (5): 333-339. doi: 10.5546/aap.2018.eng.333
9. Khirani S, Ramirez A, Aloui S, Leboulanger N, Picard A et al. Continuous positive airway pressure titration in infants with severe upper airway obstruction or bronchopulmonary dysplasia. Critical Care 2013; 17 (4): 167. doi: 10.1186/cc12846
10. Essouri S, Durand P, Chevret L, Haas V, Perot C et al. Physiological effects of noninvasive positive ventilation during acute moderate hypercapnic respiratory insufficiency in children. Intensive Care Medicine 2008; 34 (12): 2248-2255. doi: 10.1007/s00134-008-1202-9
11. Abadesso C, Nunes P, Silvestre C, Matias E, Loureiro H et al. Non-invasive ventilation in acute respiratory failure in children. Pediatric Reports 2012; 4 (2): 16. doi: 10.4081/ pr.2012.e16
12. Mortamet G, Amaddeo A, Essouri S, Renolleau S, Emeriaud G et al. Interfaces for noninvasive ventilation in the acute setting in children. Paediatric Respiratory Reviews 2017; 23: 84-88. doi: 10.1016/j.prrv.2016.09.004
13. Wang BC, Pei T, Lin CB, Guo R, Elashoff D et al. Clinical characteristics and outcomes associated with nasal intermittent mandatory ventilation in acute pediatric respiratory failure. World Journal of Critical Care Medicine 2018; 7 (4): 46-51. doi: 10.5492/wjccm.v7.i4.46
14. Morley SL. Non-invasive ventilation in paediatric critical care. Paediatric Respiratory Reviews 2016; 20: 24-31. doi: 10.1016/j. prrv.2016.03.001
15. Milesi C, Baleine J, Matecki S, Durand S, Combes C et al. Is treatment with a high flow nasal cannula effective in acute viral bronchiolitis? A physiologic study. Intensive Care Medicine 2013; 39 (6): 1088-1094. doi: 10.1007/s00134-013-2879-y
16. Rochwerg B, Brochard L, Elliott MW, Hess D, Hill NS et al. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. European Respiratory Journal 2017; 50 (2): 1602426. doi: 10.1183/13993003.02426- 2016
17. Morris JV, Ramnarayan P, Parslow RC, Fleming SJ. Outcomes for children receiving noninvasive ventilation as the first line mode of mechanical ventilation at intensive care admission: a propensity score-matched cohort study. Critical Care Medicine 2017; 45 (6): 1045-1053. doi: 10.1097/ CCM.0000000000002369
18. Pediatric Acute Lung Injury Consensus Conference Group. Pediatric acute respiratory distress syndrome: consensus recommendations from the Pediatric Acute Lung Injury Consensus Conference. Pediatric Critical Care Medicine 2015; 16 (5): 428-439. doi: 10.1097/PCC.0000000000000350
19. Feudtner, C Feinstein JA, Zhong W, Hall M, Dai D. Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation. BMC Pediatrics 2014; 14: 199. doi: 10.1186/1471-2431-14-199
20. Fleming S, Thompson M, Stevens R, Heneghan C, Plüddemann A et al. Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: a systematic review of observational studies. Lancet 2011; 377 (9770): 1011- 1018. doi: 10.1016/S0140-6736(10)62226-X
21. Mayordomo-Colunga J, Pons M, López Y, José Solana M, Rey C et al. Predicting non-invasive ventilation failure in children from the SpO2/FiO2 (SF) ratio. Intensive Care Medicine 2013;39 (6): 1095-1103. doi: 10.1007/s00134-013-2880-5
22. Bernet V, Hug MI, Frey B. Predictive factors for the success of noninvasive mask ventilation in infants and children with acute respiratory failure. Pediatric Critical Care Medicine 2005; 6 (6): 660-664. doi: 10.1097/01.pcc.0000170612.16938.f6
23. Dohna-Schwake C, Stehling F, Tschiedel E, Wallot M, Mellies U. Non-invasive ventilation on a pediatric intensive care unit: feasibility, efficacy, and predictors of success. Pediatric Pulmonology 2011; 46 (11): 1114-1120. doi: 10.1002/ ppul.21482
24. Monaghan A. Detecting and managing deterioration in children. Paediatric Nursing 2005; 17 (1): 32-35. doi: 10.7748/ paed2005.02.17.1.32.c964
25. Bakalli I, Celaj E, Simaku A, Kola E, Sallabanda S. Predictors of noninvasive ventilation success in children with acute respiratory failure. Intensive Care Medicine 2015; 41 (5): 950- 951. doi: 10.1007/s00134-015-3769-2
26. Mayordomo-Colunga J, Medina A, Rey C, Díaz JJ, Concha A et al. Predictive factors of noninvasive ventilation failure in critically ill children: a prospective epidemiological study. Intensive Care Medicine 2009; 35 (3): 527-536. doi: 10.1007/ s00134-008-1346-7
27. Kelly GS, Simon HK, Sturm JJ. High-flow nasal cannula use in children with respiratory distress in the emergency department: predicting the need for subsequent intubation. Pediatric Emergency Care 2013; 29 (8): 888-892. doi: 10.1097/ PEC.0b013e31829e7f2f
28. Mayfield S, Bogossian F, O’Malley L, Schibler A. High-flow nasal cannula oxygen therapy for infants with bronchiolitis: pilot study. Journal of Paediatrics and Child Health 2014; 50 (5): 373-378. doi: 10.1111/jpc.12509
29. Hansen G, Hochman J, Garner M, Dmytrowich J, Holt T. Pediatric early warning score and deteriorating ward patients on high-flow therapy. Pediatrics International 2019; 61 (3): 278-283. doi: 10.1111/ped.13787
30. Yaman A, Kendirli T, Ödek Ç, Ateş C, Taşyapar N et al. Efficacy of noninvasive mechanicalventilation in prevention of intubation and reintubation in the pediatric intensive care unit. Journal of Critical Care 2016; 32:175-181. doi: 10.1016/j. jcrc.2015.12.013
31. Essouri S, Chevret L, Durand P, Haas V, Fauroux B et al. Noninvasive positive pressure ventilation: five years of experience in a pediatric intensive care unit. Pediatric Critical Care Medicine 2006; 7 (4): 329-334. doi: 10.1097/01. PCC.0000225089.21176.0B
32. Bernet V, Hug MI, Frey B. Predictive factors for the success of noninvasive mask ventilation in infants and children with acute respiratory failure. Pediatric Critical Care Medicine 2005; 6 (6): 660-664. doi: 10.1097/01.pcc.0000170612.16938.f6
33. James CS, Hallewell CP, James DP, Wade A, Mok QQ. Predicting the success of non-invasive ventilation in preventing intubation and re-intubation in the paediatric intensive care unit. Intensive Care Medicine 2011; 37 (12): 1994-2001. doi: 10.1007/s00134- 011-2386-y
34. Liu J, Bell C, Campbell V, DeBacker J, Tamberg E et al. Noninvasive ventilation in patients with hematologic malignancy: a retrospective study. Journal of Intensive Care Medicine 2019; 34 (3): 197-203. doi:10.1177/0885066617690725
35. Fuchs H, Schoss J, Mendler MR, Lindner W, Hopfner R et al. The cause of acute respiratory failure predicts the outcome of noninvasive ventilation in immunocompromised children. Klinische Padiatrie 2015; 227 (6-7): 322-328. doi: 10.1055/s0034-1395692
36. Hsiung Lee ES, Jiann Lim DT, Taculod JM, Sahagun JT, Otero JP et al. Factors associated with reintubation in an intensive care unit: a prospective observational study. Indian Journal of Critical Care Medicine 2017; 21 (3): 131-137. doi: 10.4103/ ijccm.IJCCM_452_16
37. Peters MJ, Agbeko R, Davis P, Klein N, Zenasni Z et al. Randomized study of early continuous positive airways pressure in acute respiratory failure in children with impaired immunity (SCARF) ISRCTN82853500. Pediatric Critical Care Medicine 2018; 19 (10): 939-948. doi: 10.1097/ PCC.0000000000001683
38. Chacur FH, Vilella Felipe LM, Fernandes CG, Lazzarini LC. The total face mask is more comfortable than the oronasal mask in noninvasive ventilation but is not associated with improved outcome. Respiration 2011; 82 (5): 426-430. doi: 10.1159/000324441
39. Bergquist-Beringer S, Davidson J, Agosto C, Linde NK, Abel M et al. Evaluation of the national database of nursing quality indicators (NDNQI) training program on pressure ulcers. Journal of Continuing Education in Nursing 2009; 40 (6): 252- 258. doi: 10.3928/00220124-20090522-05

APA	Ongun E, dursun o, Anil A, altuğ ü, TEMEL KÖKSOY Ö, Akyıldız B, ozsoylu s, KENDIRLI T, Özcan S, yildizdas d, Arslan i, karapınar b, kılınç m, DEMIRKOL D (2021). A multicentered study on efficiency of noninvasive ventilation procedures (SAFE-NIV). , 1159 - 1171. 10.3906/sag-2004-35
Chicago	Ongun Ebru Atike,dursun oguz,Anil Ayse Berna,altuğ ümüt,TEMEL KÖKSOY ÖZLEM,Akyıldız Basak Nur,ozsoylu serkan,KENDIRLI TANIL,Özcan Serhan,yildizdas dincer,Arslan ilknur,karapınar bülent,kılınç mehmet arda,DEMIRKOL DEMET A multicentered study on efficiency of noninvasive ventilation procedures (SAFE-NIV). (2021): 1159 - 1171. 10.3906/sag-2004-35
MLA	Ongun Ebru Atike,dursun oguz,Anil Ayse Berna,altuğ ümüt,TEMEL KÖKSOY ÖZLEM,Akyıldız Basak Nur,ozsoylu serkan,KENDIRLI TANIL,Özcan Serhan,yildizdas dincer,Arslan ilknur,karapınar bülent,kılınç mehmet arda,DEMIRKOL DEMET A multicentered study on efficiency of noninvasive ventilation procedures (SAFE-NIV). , 2021, ss.1159 - 1171. 10.3906/sag-2004-35
AMA	Ongun E,dursun o,Anil A,altuğ ü,TEMEL KÖKSOY Ö,Akyıldız B,ozsoylu s,KENDIRLI T,Özcan S,yildizdas d,Arslan i,karapınar b,kılınç m,DEMIRKOL D A multicentered study on efficiency of noninvasive ventilation procedures (SAFE-NIV). . 2021; 1159 - 1171. 10.3906/sag-2004-35
Vancouver	Ongun E,dursun o,Anil A,altuğ ü,TEMEL KÖKSOY Ö,Akyıldız B,ozsoylu s,KENDIRLI T,Özcan S,yildizdas d,Arslan i,karapınar b,kılınç m,DEMIRKOL D A multicentered study on efficiency of noninvasive ventilation procedures (SAFE-NIV). . 2021; 1159 - 1171. 10.3906/sag-2004-35
IEEE	Ongun E,dursun o,Anil A,altuğ ü,TEMEL KÖKSOY Ö,Akyıldız B,ozsoylu s,KENDIRLI T,Özcan S,yildizdas d,Arslan i,karapınar b,kılınç m,DEMIRKOL D "A multicentered study on efficiency of noninvasive ventilation procedures (SAFE-NIV)." , ss.1159 - 1171, 2021. 10.3906/sag-2004-35
ISNAD	Ongun, Ebru Atike vd. "A multicentered study on efficiency of noninvasive ventilation procedures (SAFE-NIV)". (2021), 1159-1171. https://doi.org/10.3906/sag-2004-35

APA	Ongun E, dursun o, Anil A, altuğ ü, TEMEL KÖKSOY Ö, Akyıldız B, ozsoylu s, KENDIRLI T, Özcan S, yildizdas d, Arslan i, karapınar b, kılınç m, DEMIRKOL D (2021). A multicentered study on efficiency of noninvasive ventilation procedures (SAFE-NIV). Turkish Journal of Medical Sciences, 51(3), 1159 - 1171. 10.3906/sag-2004-35
Chicago	Ongun Ebru Atike,dursun oguz,Anil Ayse Berna,altuğ ümüt,TEMEL KÖKSOY ÖZLEM,Akyıldız Basak Nur,ozsoylu serkan,KENDIRLI TANIL,Özcan Serhan,yildizdas dincer,Arslan ilknur,karapınar bülent,kılınç mehmet arda,DEMIRKOL DEMET A multicentered study on efficiency of noninvasive ventilation procedures (SAFE-NIV). Turkish Journal of Medical Sciences 51, no.3 (2021): 1159 - 1171. 10.3906/sag-2004-35
MLA	Ongun Ebru Atike,dursun oguz,Anil Ayse Berna,altuğ ümüt,TEMEL KÖKSOY ÖZLEM,Akyıldız Basak Nur,ozsoylu serkan,KENDIRLI TANIL,Özcan Serhan,yildizdas dincer,Arslan ilknur,karapınar bülent,kılınç mehmet arda,DEMIRKOL DEMET A multicentered study on efficiency of noninvasive ventilation procedures (SAFE-NIV). Turkish Journal of Medical Sciences, vol.51, no.3, 2021, ss.1159 - 1171. 10.3906/sag-2004-35
AMA	Ongun E,dursun o,Anil A,altuğ ü,TEMEL KÖKSOY Ö,Akyıldız B,ozsoylu s,KENDIRLI T,Özcan S,yildizdas d,Arslan i,karapınar b,kılınç m,DEMIRKOL D A multicentered study on efficiency of noninvasive ventilation procedures (SAFE-NIV). Turkish Journal of Medical Sciences. 2021; 51(3): 1159 - 1171. 10.3906/sag-2004-35
Vancouver	Ongun E,dursun o,Anil A,altuğ ü,TEMEL KÖKSOY Ö,Akyıldız B,ozsoylu s,KENDIRLI T,Özcan S,yildizdas d,Arslan i,karapınar b,kılınç m,DEMIRKOL D A multicentered study on efficiency of noninvasive ventilation procedures (SAFE-NIV). Turkish Journal of Medical Sciences. 2021; 51(3): 1159 - 1171. 10.3906/sag-2004-35
IEEE	Ongun E,dursun o,Anil A,altuğ ü,TEMEL KÖKSOY Ö,Akyıldız B,ozsoylu s,KENDIRLI T,Özcan S,yildizdas d,Arslan i,karapınar b,kılınç m,DEMIRKOL D "A multicentered study on efficiency of noninvasive ventilation procedures (SAFE-NIV)." Turkish Journal of Medical Sciences, 51, ss.1159 - 1171, 2021. 10.3906/sag-2004-35
ISNAD	Ongun, Ebru Atike vd. "A multicentered study on efficiency of noninvasive ventilation procedures (SAFE-NIV)". Turkish Journal of Medical Sciences 51/3 (2021), 1159-1171. https://doi.org/10.3906/sag-2004-35