Role of the pediatric intensive care unit in the evaluation and support of the patient with pathology of the airway. How do we do it?
Abstract Introduction and Objective: Airway pathology comprises a broad spectrum of clinical manifestations that include different degrees of respiratory failure and / or respiratory disorders during sleep. The management is done in a multidisciplinary way, collaborating with ENT, Pediatric surgeon and Sleep Respiratory Disorders Unit. Noninvasive Ventilation (NIV) has shown its therapeutic utility in the pediatric patient, in both acute and chronic situations. The most frequent indication is acute respiratory failure. Although there are not many contraindications for its application should be known to avoid failures of this technique. Material and method: We present a review of basic concepts, indications, contraindications and our methodology of NIV in pediatric patients. Conclusions: A significant percentage of children admitted to PICU require mechanicaln ventilation. The most frequent indication is respiratory failure. In acute situations, NIV is applied to stabilize the patient, while in chronic cases can be useful during the study phase. It can be specified as support during the Fibroscopic study, and to titrate NIV parameters in supportive patients domiciliary.
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Pons M, Medina A, Esquinas A. Manual de ventilación no invasiva en pediatría. Madrid. Ergón, 2008.
Randolph AG. How are children mechanically ventilated in pediatric intensive care units? Intensive Care Med 2004;30:746-7. https://doi.org/10.1007/s00134-004-2215-7 - PMid:14991084
Raúl J. Corrales V. Ventilación mecánica no invasiva en pediatría. Consenso Chileno de Ventilación no Invasiva. Rev Chil Enf Respir 2008;24:263-5.
Urbano Villaescusa J, Mencía Bartolomé S, Cidoncha Escobar E, López-Herce Cid J, Santiago Lozano MJ, Carrillo Álvarez A. Experiencia con la oxigenoterapia de alto flujo en cánulas nasales en ni-os. An Pediatr (Barc). 2008;68(1):4-8. https://doi.org/10.1157/13114463
Balcells Ramírez J, López-Herce Cid J, Modesto Alapont V (Grupo de Respiratorio de la Sociedad Espa-ola de Cuidados Intensivos Pediátricos). Prevalencia de la ventilación mecánica en las unidades de cuidados intensivos pediátricos en Espa-a. An Pediatr (Barc). 2004;61:533-41 https://doi.org/10.1016/S1695-4033(04)78440-4
Farias JA, Frutos F, Esteban A, Casado J, Retta A, Baltodano A, et al. What is the daily practice of mechanical ventilation in pediatric intensive care units? A multicenter study. Intensive Care Med 2004;30:918-25. https://doi.org/10.1007/s00134-004-2225-5 - PMid:15029473
Fernández-Vivas M, González-Díaz G, Caturla-Such J, Delgado-Vílchez FJ, Serrano-Simón JM, Carrillo-Alcaraz A, et al. Utilización de la ventilación no invasiva en la insuficiencia respiratoria aguda. Estudio multicéntrico en unidades de cuidados intensivos. Med Intensiva. 2009;33(4):153-60. https://doi.org/10.1016/S0210-5691(09)71210-0
Ferrer M, Esquinas A, Arancibia F, Abuer TT, Gonzalez G, Carrillo A, et al. Noninvasive ventilation during persisting weaning failure: a randomized controlled trial. Am J Respir Crit Care Med. 2003;168:70-6. https://doi.org/10.1164/rccm.200209-1074OC https://doi.org/10.1164/rccm.200301-072OC
Hamel DS, Klonin H. The role of noninvasive ventilation for acute respiratory failure. Respir Care Clin N Am 2006;12:421-35. PMid:16952802
Lobete C, Medina A, Rey C, Mayordomo-Colunga J, Concha A, Menéndez S. Correlation of SF Ratio with PF ratio in a heterogeneous sample of critically ill children. J Crit Care. 2013;28:538. e1-7.
Medina Villanueva A, Prieto Espu-es S, Los Arcos Solas M, Rey Galán C, Concha Torre A, Menéndez Cuervo S, et al. Aplicación de ventilación no invasiva en una unidad de cuidados intensivos pediátricos. An Pediatr (Barc). 2005;62(1):13-9. https://doi.org/10.1157/13070175
Meert AP, Berghmans T, Hardy M, Markiewicz e, Sculier JP. Noninvasive ventilation for cancer patients with life-support techniques limitation. Support Care Cancer 2006; 14:167-71. https://doi.org/10.1007/s00520-005-0845-0 PMid:15947952
Nava S, Gregoretti C, Fanfulla F, Squadrone E, Grassi M, Carlucci A, et al. Noninvasive ventilation to prevent respiratory failure after extubation in high-risk patients. Crit Care Med. 2005;33:2465-70. https://doi.org/10.1097/01.CCM.0000186416.44752.72 - PMid:16276167
Piastra M, Antonelli M, Caresta E, Chiaretti A, Polidori G, Conti G. Noninvasive ventilation in childhood acute neuromuscular respiratory failure: a pilot study. Respiration 2006;73:791-8. https://doi.org/10.1159/000090777 - PMid:16424640
Pons M, Gili T, Medina A, Mayordomo-Colunga J. Ventilación no invasiva en pediatría. En: Medina Villanueva A, Pilar Orive J. Manual de ventilación mecánica pediátrica y neonatal. Capítulo 19. Ergón, Madrid 2015.
Pons M, Medina A, Esquinas A. Manual de ventilación no invasiva en pediatría. Madrid. Ergón, 2008.
Randolph AG. How are children mechanically ventilated in pediatric intensive care units? Intensive Care Med 2004;30:746-7. https://doi.org/10.1007/s00134-004-2215-7 - PMid:14991084
Raúl J. Corrales V. Ventilación mecánica no invasiva en pediatría. Consenso Chileno de Ventilación no Invasiva. Rev Chil Enf Respir 2008;24:263-5.
Urbano Villaescusa J, Mencía Bartolomé S, Cidoncha Escobar E, López-Herce Cid J, Santiago Lozano MJ, Carrillo Álvarez A. Experiencia con la oxigenoterapia de alto flujo en cánulas nasales en ni-os. An Pediatr (Barc). 2008;68(1):4-8. https://doi.org/10.1157/13114463
Oyagüez-Ugidos, P. P., Blanco-Gómez, I., García-González, M., & Alonso-Álvarez, M. L. (2018). Role of the pediatric intensive care unit in the evaluation and support of the patient with pathology of the airway. How do we do it?. Revista ORL, 9(1), 41–47. https://doi.org/10.14201/orl.15902
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