Utilización de cánulas nasales de alto flujo para la ventilación no invasiva en niños

Resumo

Objective To analyse the efficacy and tolerance of non-invasive mechanical ventilation (NIMV) via high-flow oxygen therapy nasal cannulae in children after withdrawal of mechanical ventilation and/or with moderate respiratory insufficiency. Patients and methods A prospective observational clinical study including 34 children between 9 months and 17years treated with NIMV via high-flow oxygen therapy nasal cannulae. The following variables were analysed: age, sex, respiratory rate, heart rate, oxygen saturation, blood gases, clinical improvement, tolerance, onset of complications and treatment failure. Results NIMV was used in 13 children after withdrawal of mechanical ventilation and in 21 with respiratory failure. A high percentage (82.3%) of patients improved clinically and/or allowed the mechanical ventilation to be withdrawn, but there were no significant changes in respiratory rate, heart rate, pH, pCO2 or saturation. NIMV was not effective in 6 patients (17.6%) and required change to a nasal or buconasal mask (5 patients) or intubation (1 patient). Two patients (5.9%) required change of interface to a nasal or buconasal mask, one had nasal erosion, and another, although improved clinically, showed excessive leakage. The duration of treatment was 48hours (range 1 to 312hours). Conclusions Non-invasive mechanical ventilation via high-flow oxygen therapy nasal cannulae is effective and well tolerated in a high percentage of children after withdrawal of mechanical ventilation or with moderate respiratory insufficiency.