PO-0265Non Invasive Ventilation For Severe Bronchiolitis

IntroductionNon-invasive ventilation (NIV) is a relatively new ventilatory mode that has been increasingly used in the acute setting over the past 15 years, demonstrating beneficial effects in the paediatric population with different types of respiratory failure.ObjectivesTo examine whether infants with severe bronchiolitis could be managed with non-invasive ventilation (NIV) alone. To study the characteristics, clinical course and outcome of NIV patients.Patients and methodsA retrospective analysis was made of infants with severe bronchiolitis in a Paediatric Intensive Care Unit admitted from 01/09/2011 to 31/01/2012 and from 01/09/2012 to 31/02/2013. One thousand and sixty-four infants with severe bronchiolitis were admitted. One thousand and two were invasively ventilated, seventy-two were treated with NIV. We aimed to examine the characteristics, clinical course and outcome for those who received NIV.ResultsSeventy-two patients, including 6 with apnea, were treated exclusively with NIV. The mean age was de 54,2 days plus or minus 39,1 (8-221). The mean respiratory rate was 61 breaths/min plus or minus 16,7 (20-104). NIV was delivered by continuous (CPAP) in seven patients, bi-level (BiPAP) positive airway pressure in thirty-four infants and high-flow nasal cannula in thirty-one patients. Twenty-three failed to respond and were invasively ventilated. Risk factors for NIV failure were prematurity and bacterial infection. Duration of hospital stay was shorter in responders. There were no major complications related with NIV.ConclusionThis study demonstrates the efficacy of NIV as a form of respiratory support for infants with severe bronchiolitis avoiding ETI in most of the patients. Risk factors for failure were related with immaturity and severe infection.