Abstract

BERNARDO, Alonso et al. Ventilación no invasiva en menores de dos años internados en sala con infección respiratoria aguda baja.: Posibles factores predictivos de éxito y de fracaso . Arch. Pediatr. Urug. [online]. 2012, vol.83, n.4, pp.250-255. ISSN 1688-1249.

Summary  Objectives: to describe the results of applying noninvasive ventilation in the years 2009 and 2010 in children under two years with acute lower respiratory tract infection and analyze potential predictors of success or failure. Design: observational, descriptive, prospective. Population: children under 2 years with lower respiratory tract infection and respiratory failure Tal score> 8, or ³ 6 and not responding to treatment. We excluded children weighing <7 kg, unstable hemodynamics, neuro-psychic depression, pneumothorax, pneumomediastinum and/or mixed acidosis. Intervention: a protocol with stabilization measures, monitoring and VNI parameters was applied. Results: we included 185 children, median age 9 months old, average weight 8.6 kg. It was successful in 151 children (81.6%). There were not statistically significant differences in age, weight and severity at admission between the group of children with treatment failure versus success. After 2 hours respiratory frequency (RF) greater than 60 rpm, heart rate (HR) increased 140 cpm and support pressure (SP) greater to 9 were associated with failure (p <0.05). Multivariate analysis showed that after 2 h the RF> 60 rpm increase the risk of failure 6.4 times (CI 95 1.9 to 21.7), HR > 140 cpm 4.3 (CI95 1.5 to 11.8) and SP > 9 it increased 8.7 times (CI95 2.3 to 32.2). Conclusion: increase in FR, HR and SP at 2 hours are potential predictors of treatment failure. Further research is needed to confirm these findings and identify the indications of this technique in these patients. 

Keywords : POSITIVE-PRESSURE RESPIRATION; RESPIRATORY TRACT INFECTIONS; BRONCHIOLITIS.

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