Noninvasive positive-pressure ventilation in children with lower airway obstruction

Peter J. Thill, John K. McGuire, Harris P. Baden, Thomas P. Green, Paul A. Checchia

Research output: Contribution to journalArticlepeer-review

117 Scopus citations

Abstract

Study Objectives: Mechanical ventilation of patients with severe lower airway obstruction presents significant risks; therefore, avoiding the intubation in these patients has been a principal goal of clinical management. Noninvasive positive-pressure ventilation has been shown to be effective in treating adults with chronic obstructive pulmonary disease, but its use has not been studied prospectively in children with acute obstructive lower airways disease. The objective of this study was to determine whether noninvasive mask ventilation improved respiratory function in children with asthma and other obstructive lower airways diseases. Study Design: A prospective, randomized, crossover study. Patients: A total of 20 children admitted to the pediatric intensive care unit with acute lower airway obstruction. Methods: Children were randomized to receive either 2 hrs of noninvasive ventilation followed by crossover to 2 hrs of standard therapy or 2 hrs of standard therapy followed by 2 hrs of noninvasive ventilation. Results: Using a Clinical Asthma Score, we found that noninvasive ventilation decreased signs of work of breathing such as respiratory rate, accessory muscle use, and dyspnea as compared with standard therapy. There was no serious morbidity associated with noninvasive ventilation. Conclusions: We conclude that noninvasive ventilation can be an effective treatment for children with acute lower airway obstruction.

Original languageEnglish (US)
Pages (from-to)337-342
Number of pages6
JournalPediatric Critical Care Medicine
Volume5
Issue number4
DOIs
StatePublished - Dec 1 2004

Keywords

  • Asthma
  • Children
  • Lower airway obstruction
  • Noninvasive ventilation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

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