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Clinical Trial
. 2008 Dec;34(12):2248-55.
doi: 10.1007/s00134-008-1202-9. Epub 2008 Aug 19.

Physiological effects of noninvasive positive ventilation during acute moderate hypercapnic respiratory insufficiency in children

Sandrine Essouri  1 , Philippe Durand, Laurent Chevret, Vincent Haas, Claire Perot, Annick Clement, Denis Devictor, Brigitte Fauroux
Affiliations
Clinical Trial

Physiological effects of noninvasive positive ventilation during acute moderate hypercapnic respiratory insufficiency in children

Sandrine Essouri et al. Intensive Care Med. 2008 Dec.

Abstract

Introduction: A prospective physiological study was performed in 12 paediatric patients with acute moderate hypercapnic respiratory insufficiency to assess the ability of noninvasive positive pressure ventilation (NPPV) to unload the respiratory muscles and improve gas exchange.

Materials and methods: Breathing pattern, gas exchange, and inspiratory muscle effort were measured during spontaneous breathing and NPPV.

Results: NPPV was associated with a significant improvement in breathing pattern, gas exchange and respiratory muscle output. Tidal volume and minute ventilation increased by 33 and 17%, and oesophageal and diaphragmatic pressure time product decreased by 49 and 56%, respectively. This improvement in alveolar ventilation translated into a reduction in mean partial pressure in carbon dioxide from 48 to 40 mmHg (P = 0.01) and in respiratory rate from 48 to 41 breaths/min (P = 0.01). No difference between a clinical setting and a physiological setting of NPPV was observed. In conclusion, this study shows that NPPV is able to unload the respiratory muscles and improve clinical outcome in young patients admitted to the paediatric intensive care unit for acute moderate hypercapnic respiratory insufficiency.

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