Non-Invasive Ventilation reduces the Stay of the Infant in the ICU

A recent study, published in the latest issue of the journal Intensive Care Medicine, has found that during the past decade, increased dependency on non-invasive ventilation for infants suffering from severe bronchiolitis, has been associated with reduced rate of intubation and a shortened stay of the infant in the ICU.

For their study, the researchers analyzed the clinical database of a tertiary 23 bed pediatric intensive care unit (PICU). The records of all the infants admitted in the PICU for severe bronchiolitis between the period of January 2000 and December 2009 were examined. The points which the researchers covered while analyzing the database included the length of stay of the infant in the PICU, their ventilator requirements, and associated risk factors like prematurity, history of infection with the respiratory syncytial virus, any history of chronic lung, neuromuscular, congenital and immune disease.

The researchers found that of all the 8,288 infants admitted in the hospital, 520 suffered from severe bronchiolitis while 343 suffered with an infection of respiratory syncytial virus. The median age of the infants admitted in the hospital was around 2.78 months. The average duration of stay in the intensive care unit was about 2.68 days. There was a need of assisted ventilation in 399 patients. Of these 114 were intubated directly while in the remaining 285 infants, a trial of non-invasive ventilation was given. An increase in the number of trials of non-invasive ventilation was associated with a decrease in the rate of intubations. Among the infants who were initially given non-invasive ventilation trials, 237 did not require any further ventilator support, whereas 48 had to be intubated as the non-invasive ventilation failed in them. The average stay of the infants in the ICU in case of non-invasive ventilation techniques was 2.38±2.43days. As compared to this, the infants who were intubated directly had a length of stay in the ICU of 5.19±6.34days while those who were intubated after the failure of non-invasive ventilator techniques stayed in the ICU for 8.41±3.44days.

The researchers concluded that non-invasive ventilation is successful in treating most cases of severe bronchiolitis and its use decreases the length of stay in the hospital by almost half.


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