Implications of Sedation During the Use of Non-invasive Ventilation in Children with Acute Respiratory Failure (SEDANIV Study)-Reference-Cited by-同舟云学术

Implications of Sedation During the Use of Non-invasive Ventilation in Children with Acute Respiratory Failure (SEDANIV Study)

Published:2024-04-04 Issue: Volume: Page:
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Barrezueta Lorena Bermúdez¹^ORCID,Mayordomo-Colunga Juan²^ORCID,Miñambres-Rodríguez María³^ORCID,Reyes Susana³^ORCID,Ramos Juan Valencia⁴^ORCID,Lopez-Fernandez Yolanda Margarita⁵^ORCID,Mendizabal Mikel⁶^ORCID,Vivanco-Allende Ana²^ORCID,Cuesta Alba Palacios⁷^ORCID,Melgares Lidia Oviedo⁷,Unzueta-Roch José Luis⁸^ORCID,López Jorge⁹^ORCID,Villalta María Teresa Jiménez¹⁰,Tejedor Maite Cuevas-Mons⁴^ORCID,González Lourdes Artacho¹¹,Olmos Ainhoa Jiménez¹²,Pons-Òdena Martí¹³^ORCID

Affiliation:

1. Hospital Clínico Universitario de Valladolid, Valladolid, Spain

2. Hospital Universitario Central de Asturias, Oviedo, Spain

3. Hospital Universitario Virgen de la Arrixaca, Murcia, Spain

4. Complejo Asistencial Universitario de Burgos, Burgos, Spain

5. Hospital Universitario de Cruces, BioBizkaia-Bizkaia Health Research Institute, Bizkaia, Spain

6. Hospital Universitario de Navarra, Pamplona, Spain

7. Hospital Universitario 12 de Octubre, Madrid, Spain

8. Hospital Infantil Universitario Niño Jesús, Madrid, Spain

9. Hospital General Universitario Gregorio Marañón, Madrid, Spain

10. Hospital Universitario Reina Sofía, Córdoba, Spain

11. Hospital Regional Universitario de Málaga, Málaga, Spain

12. Hospital Universitario Miguel Servet, Zaragoza, Spain

13. Hospital Universitario Sant Joan de Déu, Esplugues de Llobregat, Spain

Abstract

Abstract Background: The objective of this study was to analyze the effects of sedation administration on clinical parameters, comfort status, intubation requirements, and the pediatric intensive care unit (PICU) length of stay (LOS) in children with acute respiratory failure (ARF) receiving noninvasive ventilation (NIV). Methods: Thirteen PICUs in Spain participated in a prospective, multicenter, observational trial from January to December 2021. Children with ARF under the age of five who were receiving NIV were included. Clinical information and comfort levelswere documented at the time of NIV initiation, as well as at 3, 6, 12, 24, and 48 hours. The COMFORT-behavior (COMFORT-B) scale was used to assess the patients’ level of comfort. NIV failure was considered to be a requirement forendotracheal intubation. Results: A total of 457 patients were included, with a median age of 3.3 months (IQR 1.3-16.1). Two hundred and thirteen children (46.6%) received sedation (sedation group); these patients had a higher heart rate, higher COMFORT-B score, and lower S/F ratio than did those who did not receive sedation (non-sedationgroup). A significantly greater improvement in the COMFORT-B score at 3, 6, 12, and 24 hours, heart rate at 6 and 12 hours, and S/F ratio at 6 hours was observed in the sedation group. Overall, the NIV success rate was 95.6% -intubation was required in 6.1% of the sedation group and in 2.9% of the other group (p =0.092). Multivariate analysis revealed that the PRISM III score at NIV initiation (OR 1.408; 95% CI 1.230–1.611) and respiratory rate at 3 hours (OR 1.043; 95% CI 1.009–1.079) were found to be independent predictors of NIV failure. The PICU LOS was correlated with weight, PRISM III score, respiratory rate at 12 hours, SpO2 at 3 hours, FiO2 at 12 hours, NIV failure and NIV duration. Sedation use was not found to be independently related to NIV failure or to the PICU LOS. Conclusions: Sedation use may be useful in children with ARF treated with NIV, as it seems to improve clinical parameters and comfort status but may not increase the NIV failure rate or PICU LOS, even though sedated children were more severe at technique initiation in the present sample.

Publisher

Research Square Platform LLC

Reference32 articles.

1. 1. Yanez LJ, Yunge M, Emilfork M, Lapadula M, Alcantara A, Fernandez C, et al. A prospective, randomized, controlled trial of noninvasive ventilation in pediatric acute respiratory failure. Pediatr Crit Care Med. 2008;9(5):484–9.

2. 2. Abadesso C, Nunes P, Silvestre C, Matias E, Loureiro H, Almeida H. Noninvasive ventilation in acute respiratory failure in children. Pediatr Rep. 2012;4(2):e16.

3. 3. Mayordomo-Colunga J, Medina A, Rey C, Diaz JJ, Concha A, Los Arcos M, et al. Predictive factors of noninvasive ventilation failure in critically ill children: a prospective epidemiological study. Intensive Care Med. 2009;35(3):527–36.

4. 4. Pons-Odena M, Medina A, Modesto V, Martin-Mateos MA, Tan W, Escuredo L, et al. [What are the most reliable predictive factors of noninvasive ventilation failure in pediatric intensive care units?]. An Pediatr (Barc). 2019;91(5):307–16.

5. 5. Cavari Y, Sofer S, Rozovski U, Lazar I. Non invasive positive pressure ventilation in infants with respiratory failure. Pulmonol Pediatr. 2012;47(10):1019–25.