Background:Chest pain, as a common cause of hospital admissions in childhood, necessitates detailed investigations due to a wide range of differential diagnoses. In this study, we aimed to determine the distribution of diseases causing chest pain in children and investigate the clinical characteristics of children with chest pain.Methods:This study included 782 patients aged between 3 and 18 years who presented to a paediatric cardiology outpatient clinic with chest pain between April 2017 and March 2018. Aetiological causes and demographic features of the patients were analysed.Results:Most prevalent causes of chest pain were musculoskeletal system (33%) and psychogenic (28.4%) causes. Chest pain due to cardiac reasons was seen in eight patients (1%). Diseases of musculoskeletal and gastrointestinal systems and psychogenic disorders were significantly more common in male and female patients, respectively (p < 0.001 for all). In winter, patients’ age and the number of patients with ≥12 years were higher than those in other seasons (p < 0.001). Most of the parents (70.8%) and patients (90.2%) thought that chest pain in their children was caused by cardiac causes.Conclusion:Most of the diagnoses for chest pain in childhood period are benign and include the musculoskeletal system and psychogenic diseases. Although chest pain due to cardiac diseases is rare, a comprehensive analysis of medical history, detailed physical examination and cardiac imaging with echocardiography is needed to reach more accurate diagnoses.

Background: This retrospective study aimed to describe the efficacy, complications, and outcome of non-invasive mechanical ventilation (NIV) in critically ill children. Non-invasive mechanical ventilation (NIV) has achieved a significant breakthrough success in treating acute respiratory failure. NIV failure drastically increases the risk of mortality and morbidity. Many factors have been associated with the success of NIV. Methods. We performed a multicenter retrospective study using the demographic, prognostic, and laboratory findings of children (<18 years old) who were admitted in two pediatric intensive care units (PICUs). We compared clinical and laboratory variables in both successful and failed NIV groups. Results. Between January 2014 and April 2019, 1101 children were admitted to two PICU wards, of which, 403 were eligible for this study. In total, 138 (34.2%) patients received high-flow nasal cannula (HFNC), 138 (34.2%) patients received NIV-pressure control and 127 (31.6%) received NIV-pressure support (PSV). Patient mortality was 3.2% (13 patients) and the success rate of our study was 83.4%. Majority of our patients were provided NIV on admission (62.8%). Patients with successful NIV required fewer inotropic drugs, had shorter PICU stay duration, and a lower mortality rate during the follow up. The failure group presented a greater frequency of NIV-PSV and NIV-PCV use, along with higher NIV-associated complications. Logistic regression analysis revealed that NIV and HFNC failure increased PICU mortality by 19 times. Conclusions. HFNC and NIV are support modalities for respiratory distress in the PICU and were associated with a significant decrease in the PICU intubation rate.