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. 2017 Jun 1;115(3):277-281.
doi: 10.5546/aap.2017.eng.277.

Early use of continuous positive airway pressure in the treatment of moderate to severe acute lower respiratory tract infections among patients younger than 2 years old

[Article in English, Spanish]
Laura Figueroa  1 , Federico Laffaye  2
Affiliations
Free article

Early use of continuous positive airway pressure in the treatment of moderate to severe acute lower respiratory tract infections among patients younger than 2 years old

[Article in English, Spanish]
Laura Figueroa et al. Arch Argent Pediatr. .
Free article

Abstract
in English, Spanish

Objetive: To analyze the characteristics of patients younger than 2 years old who had a moderate to severe acute lower respiratory tract infection and were treated early with bubble continuous positive airway pressure, and factors associated with a successful intervention.

Method: Retrospective and descriptive study. Children younger than 2 years old admitted to the Pediatric Intermediate Care Unit of Hospital Provincial Neuquen between June 2009 and December 2010. Bubble continuous positive airway pressure was used, and the following outcomes were measured: heart rate, respiratory rate, Tal's score, oxygen saturation, and fraction of inspired oxygen at 0, 2, 6, 24, and 48 h.

Results: One hundred and twenty patients were included. Their median age was 3 months old. The intervention was successful in 72% of patients. At 2 h, a 15% reduction in respiratory rate, and a 2-point decrease in Tal's score were predictors of success, with an odds ratio of 6.41 (95% confidence interval: 2.68-15.36), and of 9.07 (95% confidence interval: 3.72-22.19), respectively.

Conclusions: A reduction in respiratory rate, heart rate, and Tal's score at 2 hours of starting the intervention were predictors of success.

Objetivo: Analizar las características de los pacientes menores de 2 años que padecieron una infección respiratoria aguda baja moderada-grave tratados precozmente con presión positiva continua en la vía aérea de burbuja y los factores asociados al éxito de la intervención.

Estudio retrospectivo y descriptivo. Niños menores de 2 años internados en Cuidados Intermedios Pediátricos del Hospital Provincial Neuquén entre junio de 2009 y diciembre de 2010. Se aplicó presión positiva continua en la vía aérea de burbuja y se midieron frecuencias cardíacas y respiratorias, puntaje de Tal, saturación y fracción inspirada de oxígeno a las 0, 2, 6, 24 y 48 h.

Resultados: Se incluyeron 120 pacientes. La mediana de edad fue 3 meses. La intervención fue exitosa en el 72% de los casos. A las 2 h, un descenso del 15% de la frecuencia respiratoria y de 2 puntos en el puntaje de Tal fueron predictores del éxito, con un OR 6,41 (IC 95%: 2,68-15,36) y 9,07 (IC 95%: 3,72-22,19), respectivamente.

Conclusiones: La disminución de la frecuencia respiratoria, de la frecuencia cardíaca y del puntaje de Tal a las 2 horas de inicio fueron predictores de éxito.

Keywords: bronchiolitis; bubble CPAP; children; pneumonia.

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