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Abstract O-14: NON-INVASIVE VENTILATION IN CHILDREN WITH PEDIATRIC ACUTE RESPIRATORY DISTRESS SYNDROME

Zeng, J.1; Wong, J.2; Qian, S.3; Ong, J.S.M.4; Gan, C.S.5; Anantasit, N.6; Chor, Y.K.7; Samransamruajkit, R.8; Phuc, P.H.9; Phumeetham, S.10; Xu, F.11; Lee, J.H.12

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 8–9
doi: 10.1097/01.pcc.0000537356.69183.f9
Oral Abstracts
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1Bei Jing Children’s Hopspital, Pediatric Intensive Care Unit, Beijing, China

2KK Women’s and Children’s Hospital, Children’s Intensive Care Unit, Singapore, Singapore

3Beijing Children’s Hospital, Pediatric Intensive Care Unit, Beijing, China

4National University Hospital, Pediatric Intensive Care Unit, Singapore, Singapore

5University Malaya Medical Centre, Department of Pediatrics, Kuala Lumpur, Malaysia

6Ramathibodi Hospital, Pediatric Department, Bangkok, Thailand

7Sarawak General Hospital, Department of Pediatrics, Kuching, Malaysia

8King Chulalongkorn Memorial Hospital, Division of Pediatric Critical Care, Bangkok, Thailand

9National Children’s Hospital, Pediatric Intensive Care Unit, Hanoi, Vietnam

10Siriraj Hospital, Department of Pediatrics-, Bangkok, Thailand

11Children’s Hospital of Chongqing Medical University, Pediatric Intensive Care Unit, Chongqing, China

12KK Women’s and Children’s Hospital, Children’s Intensive Care Unit, Singapore, Singapore

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Aims & Objectives:

The evidence supporting non-invasive ventilation (NIV) use in Pediatric Acute Respiratory Distress Syndrome (PARDS) is sparse. We aim to describe the characteristics of patients with PARDS supported with NIV.

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Methods

This is a multicenter, retrospective cohort study, from 10 pediatric intensive care units across Asia, of PARDS patients from 2009–2015. Only patients who were ventilated on NIV on the first day of PARDS was included in this study. Primary outcome was NIV failure which was defined as conversion to invasive ventilation or death.

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Results

54/438 (12.3%) patients with PARDS from 5/10 (50.0%) centers were ventilated with NIV on day 1 of PARDS and included in this analysis. The median age, Pediatric Index of Mortality 2 score and oxygen saturation/ fraction of inspired oxygen ratio was 50.3 (12.6, 110.6) months, 16.0 (9.5, 17.6) % and 156.7 (119.7, 192.5) respectively. NIV was mainly used for increased work of breathing [27/54 (50.0%)] and hypoxia [22/54 (40.7%)]. 31/54 (57.4%) were supported on bilevel positive airway pressure ventilation. NIV failure occurred in 47/54 (87.0%) and was associated with increased median length of PICU [13.0 (8.0, 25.0) vs. 5.0 (3.0, 6.0) days; p < 0.001] and hospital stay [25.0 (17.0, 38.0) vs.11.0 (8.0, 21.0) days; p = 0.018]. Overall mortality rate was 17/54 (31.5%). There was limitation of care/ do-not-resuscitate orders for 10/54 (18.5%) patients, although only 7/10 (70.0%) of these died.

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Conclusions

NIV use in PARDS was associated with high failure rate. Future studies should examine the optimal selection criteria for NIV use in PARDS.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies