Experiencia con la oxigenoterapia de alto flujo en cánulas nasales en niños

Urbano, Javier; Mencía, Santiago; Escobar, E. Cidoncha; Cid, J. López-Herce; Lozano, M.ªJ. Santiago; Álvarez, A. Carrillo

doi:10.1157/13114463

Cited by 12 publications

(3 citation statements)

References 7 publications

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“…These settings were chosen based on settings used in previous work, in conjunction with standard ventilator settings used in our ICUs. 14,15 The initial mode of nasal noninvasive ventilation was determined by the clinical team.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Effort of Breathing for Infants on Nasal Modes of Respiratory Support

Kamerkar

Hotz

Morzov

et al. 2017

The Journal of Pediatrics

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Objective To directly compare effort of breathing between high flow nasal cannula (HFNC), nasal intermittent mechanical ventilation (NIMV), and nasal continuous positive airway pressure (NCPAP). Study design This was a single center prospective cross-over study for patients <6 months in the cardiothoracic or pediatric intensive care unit receiving nasal noninvasive respiratory support after extubation. We measured effort of breathing using esophageal manometry with pressure-rate product (PRP) on all 3 modes. NIMV synchrony was determined by comparing patient efforts (esophageal manometry) with mechanically delivered breaths (spirometry in ventilator circuit). On NIMV, PRP and synchrony was also measured after adding a nasal clip on 26 patients. Results Forty-two children were included. Median (IQR) age was 2 (0.5, 4) months. There was no difference in median PRP between HFNC 6 liters per minute, 355 (270,550), NIMV 12/5 cm H2O, 341 (235, 472), and NCPAP 5 cm H2O, 340 (245,506) (P = .33). Results were similar regardless of HFNC flow rate or NIMV inspiratory pressure. Median PRP on CPAP of 5 cm H2O prior to extubation 255 (176, 375) was significantly lower than all postextubation values (P < .002). On NIMV, less than 50% of patient efforts resulted in a ventilator breath, which was not improved with a nasal clip (P > .07)). However, as NIMV synchrony improved (>60%), PRP on NIMV was lower than on HFNC. Conclusions For infants, effort of breathing is similar on HFNC, NIMV, and NCPAP after extubation, regardless of flow rate or inspiratory pressure. We speculate that bi-level NIMV may be superior if high levels of synchrony can be achieved.

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Section: Methodsmentioning

confidence: 99%

Comparison of Effort of Breathing for Infants on Nasal Modes of Respiratory Support

Kamerkar

Hotz

Morzov

et al. 2017

The Journal of Pediatrics

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“…Si llega intubado a la UCIP y no presenta complicaciones, se debe ajustar la sedación y la analgesia para disminuir rápidamente la asistencia respiratoria e intentar retirar la ventilación mecánica en las primeras 24 h de postoperatorio. La utilización de ventilación no invasiva y la oxigenoterapia de alto flujo son técnicas que pueden ayudar a facilitar la extubación precoz tras la cirugía cardíaca 15,16 .…”

Section: Discussionunclassified

Factores de riesgo de la ventilación mecánica prolongada de niños con cirugía cardíaca

et al. 2008

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“…En las UCIP [8,9] se proporciona asistencia a pacientes con patologías respiratorias diversas, tanto agudas como crónicas: problemas de vía aérea, cuadros obstructivos, enfermedades de tipo restrictivo y patología neuromuscular [10][11][12][13][14][15]. El manejo de pacientes con patología de vía aérea se realiza de forma multidisciplinar, colaborando con ORL, cirugía Infantil y unidad de trastornos respiratorios del sueño.…”

Section: Papel De Las Unidades De Cuidados Intensivos Pediátricosunclassified

Papel de la unidad de cuidados intensivos pediátricos en la evaluación y soporte del paciente con patología de la vía aérea. ¿Cómo lo hacemos?

et al. 2017

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Experiencia con la oxigenoterapia de alto flujo en cánulas nasales en niños

Cited by 12 publications

References 7 publications

Comparison of Effort of Breathing for Infants on Nasal Modes of Respiratory Support

Comparison of Effort of Breathing for Infants on Nasal Modes of Respiratory Support

Factores de riesgo de la ventilación mecánica prolongada de niños con cirugía cardíaca

Papel de la unidad de cuidados intensivos pediátricos en la evaluación y soporte del paciente con patología de la vía aérea. ¿Cómo lo hacemos?

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