RT Journal Article
SR Electronic
T1 SIMVS (synchronized intermittent <em>mandatory ventilation</em><em>)</em> mode and BCPAP (Boussignac continous positive airway pressure) system indifficult-to -wean critically ill infants from mechanical ventilation
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA2183
DO 10.1183/13993003.congress-2016.PA2183
VO 48
IS suppl 60
A1 Anna Michela Gaeta
A1 Anna Annunziata
A1 Rosa Cauteruccio
A1 Gianfranco Scotto di Frega
A1 Maria Antonietta Mazza
A1 Giuseppe Fiorentino
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA2183.abstract
AB Introduction: In pediatrics, the efficacy of weaning protocols is still controversial because the information reported is less consistent, so that as there are not yet reliable criteria for weaning and extubation. The aim of this study is to evaluate the use of low-level BCPAP in the weaning process from invasive mechanical ventilation (IMV) in infants with chronic respiratory failure (CRF) secondary to congenital heart disease, after cardiac surgical correction.Methods: We studied 12 critically ill infants, aged between 3 and 20 months with CRF, univenticular congenital heart disease surgically corrected, on IMV with SIMV mode, through tracheostomy tube. It was not possible to wean them according to classical procedures. We performed the weaning process with the progressive increase of the diameter of the cannula and the progressive reduction of pressure support and acts in SIMV mode, while spontaneous breathing cycles were performed with BCPAP.Results: The patients had a median stay of 48 days in the intensive care unit (ICU). In particular, ten patients presented respiratory infection. For them the endotracheal tube was utilized for a median of 25 days. Two patients didn't present infectious complication. They underwent endotracheal IMV for a median of 18.5 days. All patients received BCPAP for a median of 14 days. The lightweight BCPAP system didn't present tube obstructions or accidental decannulations.Conclusion: BCPAP is well tolerated in critical infants on IMV and can reduce the duration of ventilation weaning process and ICU stay, without severe complications.