Non-invasive mechanical ventilation in acute viral bronchiolitis: retrospective cohort study
DOI:
https://doi.org/10.15448/1983-652X.2017.4.26084Keywords:
bronchiolitis viral, noninvasive ventilation, pediatrics.Abstract
Objective: To evaluate the use of non-invasive mechanical ventilation (NIMV) on clinical parameters in the first 24 hours in patients hospitalized in a pediatric emergency with diagnosis of acute viral bronchiolitis (AVB).
Materials and Methods: A retrospective cohort study including medical records of children hospitalized with a diagnosis of AVB who used NIV in the pediatric emergency for two consecutive winters. Collected data: demographic (sex, age), clinical characteristics (heart rate, respiratory rate, peripheral oxygen saturation), time of use of NIV, hospitalization in pediatric ICU and length of hospital stay. Friedman and Wilcoxon tests were used to compare clinical variables between each time period, Mann-Withney test and ANOVA for comparisons between the group that used and did not use NIV.
Results: The sample consisted of 14 patients, the most prevalent type of virus was respiratory syncytial virus (RSV), and the noninvasive ventilation mode predominantly used was CPAP. There was no significant difference in vital signs in relation to the time of installation of NIV, six, 12 and 24 hours. There was no significant difference in the use of supplemental oxygen between the time of installation of NIV and after 24 hours. When comparing the clinical characteristics of patients who failed NIV and required invasive ventilation, heart rate differed significantly both at the time of installation of NIV and after 6 hours.
Conclusion: There was a significant reduction in the need for supplemental oxygen 24 hours after installation of NIV. There was no significant difference in the other clinical characteristics of the patients.
References
Pupin MK, Riccetto AGL, Ribeiro JD, Baracat ECE. Comparação dos efeitos de duas técnicas fisioterapêuticas respiratórias em parâmetros cardiorrespiratórios de lactentes com bronquiolite viral aguda. J Bras Pneumol. 2009;35(9):860-7. https://doi.org/10.1590/S1806-37132009000900007
Gomes ELFD, Postiaux G, Medeiros DRL, Monteiro KKDS, Sampaio LMM, Costa D. Chest physical therapy is effective in reducing the clinical score in bronchiolitis: randomized controlled trial. Rev Bras Fisioter. 2012;16(3):241-7. https://doi.org/10.1590/S1413-35552012005000018
Sudbrack S, Ponzi D, Massuco L, Coral C, Stein PT, Pitrez PMC. Prevalência de vírus respiratórios em lactentes com bronquiolite aguda e sibilância recorrente em uma emergência pediátrica no sul do Brasil. Sci Med. 2007;17(3):124-9.
Sparremberger DAH, Luisi F, Azevedo AV, Ribeiro AET, Wiemann AFW, de Conto BF, Munhoz BZ, Morais EFM, Bergmann GA, Maróstica LC, Valiati LS, Spinelli LF, Sussela LAO, Nunes MR, Regert R, Lardi SL, Pinto LA, Stein RT. Características epidemiológicas e influência da coinfecção por vírus respiratórios na gravidade da bronquiolite aguda em lactentes. Sci Med. 2011;21(3):101-6.
Luisi F. O papel da fisioterapia respiratória na bronquiolite viral aguda. Sci Med. 2008;18(1):39-44.
Leader S, Kohlhase K. Recent trends in severe respiratory syncytial virus (RSV) among US infants, 1997 to 2000. J Pediatr. 2003;143(Suppl 5):S127-32. https://doi.org/10.1067/S0022-3476(03)00510-9
Perrotta C, Ortiz Z, Roque M. Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old. Cochrane Database Syst Rev. 2005;(2):CD004873. https://doi.org/10.1002/14651858.CD004873.pub2
American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis. Diagnosis and management of bronchiolitis. Pediatrics. 2006;118(4):1774-93. https://doi.org/10.1542/peds.2006-2223
Javouhey E, Barats A, Richard N, Stamm D, Floret D. Non-invasive ventilation as primary ventilatory support for infants with severe bronchiolitis. Intensive Care Med. 2008;34(9):1608-14. https://doi.org/10.1007/s00134-008-1150-4
Nizarali Z, Cabral M, Silvestre C, Abadesso C, Nunes P, Loureiro H, Almeida H. Ventilação não invasiva na insuficiência respiratória aguda na bronquiolite por vírus sincicial respiratório. Rev Bras Ter Intensiva. 2012;24(4):375-80. https://doi.org/10.1590/S0103-507X2012000400014
Cambonie G, Milési C, Jaber S, Amsallem F, Barbotte E, Picaud JC, Matecki S. Nasal continuous positive airway pressure decreases respiratory muscles overload in young infants with severe acute viral bronchiolitis. Intensive Care Med. 2008;34(10):1865-72. https://doi.org/10.1007/s00134-008-1201-x
Loh LE, Chan YH, Chan I. Noninvasive ventilation in children: a review. J Pediatr (Rio J). 2007;83(2 Suppl):S91-9. https://doi.org/10.2223/JPED.1613
Najaf-Zadeh A, Leclerc F. Noninvasive positive pressure ventilation for acute respiratory failure in children: a concise review. Ann Intensive Care. 2011;1(1):15. https://doi.org/10.1186/2110-5820-1-15
Calderini E, Chidini G, Pelosi P. What are the current indications for noninvasive ventilation in children? Curr Opin Anaesthesiol. 2010;23(3):368-74. https://doi.org/10.1097/ACO.0b013e328339507b
Essouri S, Laurent M, Chevret L, Durand P, Ecochard E, Gajdos V, Devictor D, Tissières P. Improved clinical and economic outcomes in severe bronchiolitis with pre-emptive nCPAP ventilatory strategy. Intensive Care Med. 2014;40(1):84-91. https://doi.org/10.1007/s00134-013-3129-z
Milési C, Matecki S, Jaber S, Mura T, Jacquot A, Pidoux O, Chautemps N, Novais AR, Combes C, Picaud JC, Cambonie G. 6 cmH2O continuous positive airway pressure versus conventional oxygen therapy in severe viral bronchiolitis: a randomized trial. Pediatr Pulmonol. 2013;48(1):45-51. https://doi.org/10.1002/ppul.22533
Cambret Y, Prieur G, Le Roux P, Médrinal C. Non-invasive ventilation improves respiratory distress in children with acute viral bronchiolitis: a systematic review. Minerva Anestesiol. 2017;83(6): 624-37.
Alvarez AE, Marson FAL, Bertuzzo CS, Arns CW, Ribeiro JD. Epidemiological and genetic characteristics associated with the severity of acute viral bronchiolitis by respiratory syncytial virus. J Pediatr (Rio J). 2013;89(6):531-43. https://doi.org/10.1016/j.jped.2013.02.022
O-oro G, Suárez EP, Bouzas MII, Serrano A, De Azagra AM, García-Teresa MA, Flores JC. Bronquiolitis grave. Cambios epidemiológicos y de soporte respiratório. An Pediatr (Barc). 2011;74(6):371-6. https://doi.org/10.1016/j.anpedi.2011.01.012
Stockman LJ, Curns AT, Anderson LJ, Fisher-Langley G. Respiratory syncytial virus-associated hospitalizations among infants and young children in the United States, 1997-2006. Pediatr Infect Dis J. 2012;31(1):5-9. https://doi.org/10.1097/INF.0b013e31822e68e6
Fryzek JP, Martone WJ, Groothuis JR. Trends in chronologic age and infant respiratory syncytial virus hospitalization: an 8-year cohort study. Adv Ther. 2011;28(3):195-201. https://doi.org/10.1007/s12325-010-0106-6
Rödl S, Resch B, Hofer N, Marschitz I, Madler G, Eber E, Zobel G. Prospective evaluation of clinical scoring systems in infants with bronchiolitis admitted to the intensive care unit. Eur J Clin Microbiol Infect Dis. 2012;31(10):2667-72. https://doi.org/10.1007/s10096-012-1612-z
Hervás D, Reina J, Ya-es A, del Valle JM, Figuerola J, Hervás JA. Epidemiology of hospitalization for acute bronchiolitis in children: differences between RSV and non-RSV bronchiolitis. Eur J Clin Microbiol Infect Dis. 2012;31(8):1975-81. https://doi.org/10.1007/s10096-011-1529-y
Gonzaga AT, Figueira BBD, Sousa JMA, Carvalho WB. Tempo de ventilação mecânica e desenvolvimento de displasia bronco-pulmonar. Rev Assoc Med Bras. 2007;53(1):64-7. https://doi.org/10.1590/S0104-42302007000100022
Gouyon JB, Rozé JC, Guillermet-Fromentin C, Glorieux I, Adamon L, Di Maio M, Miloradovich T, Anghelescu D, Pinguier D, Escande B, Elleau C. Hospitalizations for respiratory syncytial virus bronchiolitis in preterm infants at <33 weeks gestation without bronchopulmonary dysplasia: the CASTOR study. Epidemiol Infect. 2013;141(4): 816-26. https://doi.org/10.1017/S0950268812001069
Nunes P, Abadesso C, Almeida E, Silvestre C, Loureiro H, Almeida H. Ventilação não invasiva numa unidade de cuidados intensivos pediátricos. Acta Med Port. 2010;23(3):399-404.
Essouri S, Durand P, Chevret L, Balu L, Devictor D, Faroux B, Tissières, P. Optimal level of nasal continuous positive airway pressure in severe viral bronchiolitis. Intensive Care Med. 2011;37(12): 2002-7. https://doi.org/10.1007/s00134-011-2372-4
Borckink I, Essouri S, Laurent M, Albers MJIJ, Burgerhof JGM, Tissières P, Kneyber MC. Infants with severe respiratory syncytial virus needed less ventilator time with nasal continuous airways pressure then invasive mechanical ventilation. Acta Paediatr. 2014;103(1):81-5. https://doi.org/10.1111/apa.12428
Mayordomo-Colunga J, Medina A, Rey C, Díaz JJ, Concha A, Los Arcos M, Menéndez S. Predictive factors of non invasive ventilation failure in critically ill children: a prospective epidemiological study. Intensive Care Med. 2009;35(3):527-36. https://doi.org/10.1007/s00134-008-1346-7
Abadesso C, Nunes P, Silvestre C, Matias E, Loureiro H, Almeida H. Non-invasive ventilation in acute respiratory failure in children. Pediatr Rep. 2012;4(2):e16. https://doi.org/10.4081/pr.2012.e16
Downloads
Published
Issue
Section
License
COPYRIGHT
The submission of originals to Ciência & Saúde implies the transfer by the authors of the right for publication. Authors retain copyright and grant the journal right of first publication. If the authors wish to include the same data into another publication, they must cite Ciência & Saúde as the site of original publication.
CREATIVE COMMONS LICENSE
As this journal is open access, the articles are allowed free use in scientific and educational applications, with citation of the source.
According to the type of Creative Commons License (CC-BY 4.0) adopted by Ciência & Saúde , the user must respect the requirements below.
You are free to:
Share — copy and redistribute the material in any medium or format.
Adapt — remix, transform, and build upon the material for any purpose, even commercially.
However, only under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests Ciência & Saúde endorses you or your use.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
For more details on the Creative Commons license, please follow the link in the footer of this website.
