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Tytuł:
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Change in Frequency of Invasive and Noninvasive Respiratory Support in Critically Ill Pediatric Subjects.
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Autorzy:
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Nikolla DA; Department of Emergency Medicine, Allegheny Health Network, Erie, Pennsylvania. .
Ata A; Department of Emergency Medicine, Albany Medical Center, Albany, New York.
Brundage N; Virtual Pediatric Systems, Los Angeles, California.
Carlson JN; Department of Emergency Medicine, Allegheny Health Network, Erie, Pennsylvania.
Frisch A; Department of Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Wang HE; Department of Emergency Medicine, University of Alabama Birmingham, Birmingham, Alabama.
Markovitz B; Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California.
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Źródło:
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Respiratory care [Respir Care] 2021 Aug; Vol. 66 (8), pp. 1247-1253. Date of Electronic Publication: 2021 May 04.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: <1983-> : Dallas, TX : Daedalus Enterprises for the American Association for Respiratory Therapy
Original Publication: Philadelphia : Lippincott, c1971-
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MeSH Terms:
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Noninvasive Ventilation*
Respiratory Insufficiency*/therapy
Child ; Critical Illness ; Humans ; Infant ; Intensive Care Units, Pediatric ; Intubation, Intratracheal
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Contributed Indexing:
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Keywords: airway management; critical care; endotracheal intubation; noninvasive ventilation; pediatric intensive care units; respiratory failure
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Entry Date(s):
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Date Created: 20210505 Date Completed: 20210802 Latest Revision: 20230322
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Update Code:
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20240104
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DOI:
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10.4187/respcare.08712
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PMID:
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33947789
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Background: Noninvasive respiratory support has become more popular in the pediatric population and may prevent or replace invasive procedures, such as endotracheal intubation, in certain circumstances. The objective was to examine the frequency of invasive and noninvasive respiratory support from 2009 to 2017 in critically ill pediatric patients and to determine patient-related factors associated with invasive support using the Virtual Pediatric Systems, LLC database.
Methods: This was an analysis of prospectively collected data on admissions with respiratory support from 17 pediatric ICUs from 2009 to 2017 reported within the Virtual Pediatric Systems database. We determined the frequency of invasive and noninvasive respiratory support over the study period by measuring the number of admissions with either invasive or noninvasive support within a given year divided by the total number of pediatric ICU admissions with respiratory support during the same year. Factors associated with invasive support were examined in univariate and multivariate regressions.
Results: A total of 69,262 cases of respiratory support were included. There was a decrease in the rate of invasive support over the study period from 66.9% to 48.5% ( P value for test of trend < .001) and an increase in the rate of noninvasive support from 28.7% to 57.7% ( P value for test of trend < .001). Trauma cases and subjects < 1 month old were more likely to receive invasive support. Cases occurring in later years and subjects with Black or Hispanic race were less likely to receive invasive support.
Conclusions: From 2009 to 2017, the frequency of admissions with invasive respiratory support decreased, and those with noninvasive respiratory support increased. By 2017, the frequency of noninvasive respiratory support was greater than that of invasive respiratory support.
Competing Interests: Dr Carlson has disclosed a relationship with the American Heart Association. The remaining authors have disclosed no conflicts of interest.
(Copyright © 2021 by Daedalus Enterprises.)
