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

Incidence and Epidemiology (PARDIE) Investigators and Pediatric Acute Lung Injury and SepsisInvestigators (PALISI) Network, Guillaume Emeriaud, Marti Pons-Òdena, Anoopindar K. Bhalla, Steven L. Shein, Elizabeth Y. Killien, Vicent Modesto i Alapont, Courtney Rowan, Florent Baudin, John C. Lin, Gabrielle Grégoire, Natalie Napolitano, Juan Mayordomo-Colunga, Franco Diaz, Pablo Cruces, Alberto Medina, Lincoln Smith, Robinder G. Khemani, Jesica Sforza, Rossana PoteralaAnalia Fernandez, Antonio Avila Vera, Daniel Orqueda, Nilda AguedaVidal, Deheza Rosemary, Gonzalo Turon, Cecilia Monjes, Segundo Fernando Espanol, Alejandro Siaba Serrate, Thomas Iolster, Silvio Torres, Karina Cinquegrani, Maria Jose Montes, Patricia Capocasa, Marcela Ferreyra, Pablo Castellani, Martin Giampieri, Claudia Pedraza, Luis Martin Landry, Maria Althabe, Yanina Vanesa Fortini, Priscila Botta, Fernando Paziencia, Simon Erickson, Samantha Barr, Sara Shea, Warwick Butt, Carmel Delzoppo, Alyssa Pintimalla, Alejandro Fabio Martinez Leon, Gustavo Alfredo Guzman Rivera, Philippe Jouvet, Guillaume Emeriaud, Mariana Dumitrascu, Mary Ellen French, I. Daniel Caro, Andres E. Castillo, Pablo Cruces Romero, Tania Medina, Paula Pavez Madrid, Ambar Cortez, Jimena Alvear, Carlos Acuna, Franco Diaz, Maria Jose Nunez, Adriana Wegner Araya, Loreto Godoy Mundaca, Yang Chen, German Perez Lozano, Rosalba Pardo Carrero, Yurika Paola Lopez Alarcon, Liliana Mazzillo Vega, Ledys Maria Izquierdo, Byron Enrique Piñeres Olave, Cesar Zuluaga Orrego, Deyanira Quinonez Lopez, Pablo Vasquez Hoyos, Martin Vavrina, Jiri Zurek, Santiago Campos-Miño, Rocio Yerovi, Armelle Bridier, Valerie Payen, Christophe Milesi, Pierre Bourgoin, Brendan Travert, Mathieu Genuini, Julie Starck, Matthieu Maria, Julie Guichoux, Florent Baudin, George Briassoulis, Stavroula Ilia, Matteo Di Nardo, Anna Camporesi, Fabrizio Chiusolo, Nobuaki Shime, Shinichiro Ohshimo, Yoshiko Kida, Michihito Kyo, Yuichi Tabata, Swee Fong Tang, Chian Wern Tai, Lucy Chai See Lum, Ismail Elghuwael, Nestor Javier Jimenez Rivera, Alberto E. Jarillo Quijada, Martin Kneyber, Sandra Dijkstra, John Beca, Claire Sherring, Miriam Rea, G. Sonia I. Vargas, Daniel Vasquez Miranda, Grimaldo Ramirez Cortez, Jose Tantalean, Izabela Pagowska-Klimek, Carlos Gil Escobar, Marta Sousa Moniz, Cristina Camilo, Tarek Hazwani, Nedaa Aldairi, Ahmed Al Amoudi, Ahmad Alahmadti, Ryan Taylor, Mikel Mendizabal, Concepcion Goni Orayen, Yolanda Lopez Fernandez, Juan Ramon Valle, Lidia Martinez, Javier Pilar Orive, Marta Brezmes, Jesus Lopez-Herce, Julio Parrilla, Mirella Gaboli, Jose Manuel Gonzalez Gomez, Antonio Morales Martinez, Vicent Modesto I. Alapont, Juan Ignacio Sanchez Diaz, Ana M. Llorente de la Fuente, Daniel Palanca Arias, Paula Madurga Revilla, Amelia Martinez de Azagra, Maria Garcia Gonzalez, David Arjona Villanueva, Paula Garcia Casas, Sonia Brio Sanagustin, Marti Pons Odena, Alberto Medina, Eider Onate Vergara, Patricia RodriguezCampoy, Susana Reyes Dominguez, Oguz Dursun, Ebru Atike Ongun, Fulya Kamit Can, Ayse Berna Anil, Paul Baines, Laura Walsh, Dawn Jones, Kalaimaran Sadasivam, Reinout Mildner, Adrian Plunkett, Jon Lillie, Shane Tibby, Paul Wellman, Holly Belfield, Joe Brierley, Troy E. Dominguez, Eugenia Abaleke, Yael Feinstein, Akash Deep, Santosh Sundararajan, Siva Oruganti, Catarina Silvestre, James Weitz, Victoria Sheward, Duncan Macrae, Angela Aramburo, Peter Marc Fortune, Gayathri Subramanian, Claire Jennings, Buvana Dwarakanathan, David Inwald, Calandra Feather, Rachel Agbeko, Angela Lawton-Woodhall, Karen McIntyre, Kim Sykes, Jon Pappachan, Helen Gale, Christie Mellish, Jenni McCorkell, Luis Torero, Ryan Nofziger, Samir Latifi, Heather Anthony, Ron Sanders, Glenda Hefley, Manpreet Virk, Nancy Jaimon, Philip Spinella

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

OBJECTIVES: 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, Pao2/Fio2was 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, Pao2/Fio2less than 100, and immunosuppression all present. Among patients with Pao2/Fio2greater 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.

Original languageEnglish
Pages (from-to)715-726
Number of pages12
JournalPediatric Critical Care Medicine
Volume24
Issue number9
DOIs
StatePublished - Sep 1 2023

Keywords

  • immunosuppression
  • mechanical ventilation
  • pediatric critical care
  • respiratory distress
  • tracheal intubation

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