Noninvasive positive-pressure ventilation in pediatric status asthmaticus

Akingbola, Olugbenga; Simakajornboon, Narong; Hadley, Edwin F.; Hopkins, Robert L.

doi:10.1097/00130478-200204000-00017

Cited by 66 publications

(29 citation statements)

References 15 publications

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“…1 NIV is associated with improved mortality in adult patients with COPD and other forms of respiratory distress. [2][3][4][5][6][7][8][9][10][11][12] One randomized controlled trial 13 and several small observational studies [14][15][16] found NIV safe and effective in supporting children with respiratory failure, including patients with asthma not responding to conventional therapies.…”

Section: Introductionmentioning

confidence: 99%

Bronchodilator Delivery During Simulated Pediatric Noninvasive Ventilation

et al. 2013

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BACKGROUND: Noninvasive ventilation (NIV) is usually applied using bi-level positive airway pressure devices, and many of these devices use a single-limb patient circuit with an integrated leak port to purge the circuit of exhaled carbon dioxide. Sometimes bronchodilator therapy is indicated in pediatric patients, but there have been no studies of the optimal nebulizer position, with respect to leak, during pediatric NIV. We hypothesized that there would be no differences in albuterol delivery with a vibrating-mesh nebulizer between 3 different positions/exhalation leak valve combinations in the patient circuit during simulated pediatric NIV. METHODS: A simulated upper airway model was attached to a lung model that simulated spontaneous breathing. A noninvasive ventilator equipped with heated wire circuit and heated humidifier was attached to the lung model via a pediatric oronasal mask. Albuterol (5 mg) was delivered with a vibrating-mesh nebulizer, at 3 different circuit position/leak condition combinations: prior to the humidifier and leak valve; between the humidifier and leak valve; and integrated within the mask and after the leak. Albuterol was captured on a filter and quantified with chromatography. RESULTS: Greater albuterol mass was delivered to the filter with the nebulizer integrated into the mask than at any other testing condition (P < .001). In the conditions where the nebulizer was placed prior to the exhalation leak valve, greater drug delivery was observed when the nebulizer was placed proximal to the mask (position 2) than when placed prior to the humidifier (position 3, P ‫؍‬ .002). CONCLUSIONS: Albuterol delivery during simulated pediatric NIV was affected by the position of the nebulizer in relation to the expiratory leak valve and the nebulizer's distance from the filter. A vibrating-mesh nebulizer placed intra-mask may provide a better alternative for medication delivery than those previously used during pediatric NIV.

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Section: Introductionmentioning

confidence: 99%

Bronchodilator Delivery During Simulated Pediatric Noninvasive Ventilation

et al. 2013

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“…Furthermore, reports note complications after intubation of the asthmatic patient [4][5][6]. When traditional therapies are insufficient, bilevel positive airway pressure (BiPAP) has been a safe and effective asthma therapeutic intervention in the pediatric emergency department (PED) and pediatric intensive care unit (PICU) [7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“…However, use of BiPAP as a beneficial treatment modality for acute severe asthma exacerbations in children is becoming more widely described and accepted in children of all weights [6][7][8][9][10][11][12][13][14][15][16][17][18][19]. The purpose of this study is to assess and report the safety of BiPAP use with traditional therapies for the treatment of acute severe asthma exacerbations in children who weigh 20 kg or less in the PED population.…”

Section: Introductionmentioning

confidence: 99%

Safety and clinical findings of BiPAP utilization in children 20 kg or less for asthma exacerbations

et al. 2011

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“…Author Study (n) Year of publication Population Akingbola et al (4) Case report (2) 1993 Children with atelectasis Fortenberry et al (5) Case series (28) 1995 Children with ARF Padman et al (6) Case series (34) 1998 Patients aged between 6 months and 18 years with ARF Sprague et al (7) Case series (5) 2000 Patients aged between 12 years and 18 years with ARF secondary to cystic fibrosis Akingbola et al (8) Case report (3) 2002 Children with asthma and hypercapnia Shah et al (9) Systematic review 2003 Children with bronchiolitis in ARF Thill et al (10) Randomized crossover clinical trial (16) 2004 Children with lower airways obstruction Piastra et al (11) Case series (4) 2004 Children aged between 9 and 17 years with acute leukemia and hypoxemic ARF Villanueva et al (12) Case series (23) 2005 Hypoxemic and hypercapnic ARF or respiratory failure after extubation Chin et al (13) Case series (15) 2005 Children aged 5 months and 14 years, submitted to liver transplant, that progressed with ARF and atelectasis Prado et al (14) Case series (14) 2005 Children aged between 1 month and 13 years, with ARF, reduced oxygenation (saturation < 93% with FiO2 > 40%) and ventilation (pH < 7,25), besides radiological impairment Carroll e Schramm (15) Case series (5) 2006 Children aged between 2 years and 18 years, with acute asthma, hypoxemia and increased respiratory work Essouri et al (16) Retrospective cohort (114 (20) Retrospective study 2007 Twenty patients with mean ages of 7.4 years, with ARF, received NIV and were divided into two groups for analysis: hypoxic and hypercapneic group. Codazzi et al (21) Case series (15) 2006 Fifteen children from 1 month to 5 years with hypoxemic ARF Piastra et al hypoxic group and hypercapnic group.…”

Section: Stregth Of Recommendationmentioning

confidence: 99%

Noninvasive ventilation for acute respiratory failure in children – a systematic review

Gonzaga

Silva

Alonso

et al. 2011

Einstein (São Paulo)

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Objective: To assess the role of noninvasive ventilation in the treatment of children with acute respiratory failure. Methods: A systematic review of literature on noninvasive ventilation in MEDLINE, LILACS, EMBASE, and Cochrane databases, besides references in articles. The outcomes evaluated were responses in blood oxygenation and ventilation, and patient survival. Results: A total of 120 studies on noninvasive ventilation were found as of May, 2010. Of these, only 19 were about noninvasive ventilation in children. On the other hand, there are prospective and cohort clinical trials leading to a level II quality of evidence concerning the use of noninvasive ventilation in children. Conclusion: There is scientific evidence for proposing the use of noninvasive ventilation, with a B-II degree of recommendation. Keywords

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Noninvasive positive-pressure ventilation in pediatric status asthmaticus

Cited by 66 publications

References 15 publications

Bronchodilator Delivery During Simulated Pediatric Noninvasive Ventilation

Bronchodilator Delivery During Simulated Pediatric Noninvasive Ventilation

Safety and clinical findings of BiPAP utilization in children 20 kg or less for asthma exacerbations

Noninvasive ventilation for acute respiratory failure in children – a systematic review

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