Pediatrics |

Nasal Noninvasive Ventilation and Pneumothorax in the Pediatric Population FREE TO VIEW

Beth Johnson, NP; Gwenyth Fischer, MD
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University of Minnesota Amplatz Children's Hospital, Minneapolis, MN

Chest. 2014;145(3_MeetingAbstracts):447A. doi:10.1378/chest.1780455
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SESSION TITLE: Pediatric Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Non-invasive ventilation (NIV) is frequently used in pediatric intensive care units for patients requiring an escalated level of respiratory support. Recent literature suggests that utilizing NIV in acute respiratory failure may prevent tracheal intubation, and also promotes early extubation in specific patient populations. However, there is little data available regarding complications associated with NIV in pediatric patients. We present a case series of five pediatric patients that developed pneumothorax while on the RAM cannula.

METHODS: Five patient charts where an infant patient was receiving non-invasive cpap/bipap at the time of developing pneumothorax were reviewed and described.

RESULTS: All five patients were located in the pediatric ICU at the time of pneumothorax development, and were on various settings on a non-invasive bipap RAM cannula. The settings ranged from CPAP to Bipap with a high rate. Two of the five patients were found to have a pneumothorax following feeding tube placement.

CONCLUSIONS: We conclude that while NIV is a safe and effective way to deliver respiratory support, there are potential complications that providers should be aware of should acute respiratory compromise occur. We also note that placement of a feeding tube obstructing a nare in correlation with the use of non-invasive nasal cpap/bipap may increase the risk of pneumothorax.

CLINICAL IMPLICATIONS: Although RAM cpap/bipap has clear benefits in the pediatric population and should continue to be used, further studies need to be done to assess the complications associated with this new technology, including the association with pneumothorax seen in this case series.

DISCLOSURE: The following authors have nothing to disclose: Beth Johnson, Gwenyth Fischer

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