Noninvasive ventilation via bilevel positive airway pressure support in pediatric practice

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Abstract
To evaluate the efficacy of bilevel positive airway pressure support in critically ill children with underlying medical conditions. Prospective, clinical study. Pediatric intensive care unit (ICU). Thirty-four patients (6 mos to 20 yrs, mean 11.06 +/- 0.9 yrs) with impending respiratory failure were enrolled in the study. All patients required airway or oxygenation/ventilation support (awake or asleep) and required admission to our pediatric ICU. Each patient served as his or her own control. Exclusion criteria were absent cough or gag reflex, multiple organ system failure, age of 90% of patients studied, resulting in only an 8% frequency of intubation. The efficacy of bilevel positive airway pressure support ventilation in selected groups of patients indicates the need to include this form of noninvasive pressure support ventilation in the care offered by pediatric ICUs. (Crit Care Med 1998; 26:169-173)