Feasibility of non-invasive pressure support ventilation in infants with respiratory failure after extubation: a pilot study

Intensive Care Med. 2009 Sep;35(9):1623-7. doi: 10.1007/s00134-009-1536-y. Epub 2009 Jun 17.


Objective: To evaluate the feasibility and effects of non-invasive pressure support ventilation (NIV) on the breathing pattern in infants developing respiratory failure after extubation.

Design: Prospective pilot clinical study; each patient served as their own control.

Setting: A nine-bed paediatric intensive care unit of a tertiary university hospital.

Patients: Six patients (median age 5 months, range 0.5-7 months; median weight 4.2 kg, range 3.8-5.1 kg) who developed respiratory failure after extubation.

Interventions: After a period of spontaneous breathing (SB), children who developed respiratory failure were treated with NIV.

Measurements and results: Measurements included clinical dyspnoea score (DS), blood gases and oesophageal pressure recordings, which were analysed for respiratory rate (RR), oesophageal inspiratory pressure swing (dPes) and oesophageal pressure-time product (PTPes). All data were collected during both periods (SB and NIV). When comparing NIV with SB, DS was reduced by 44% (P < 0.001), RR by 32% (P < 0.001), dPes by 45% (P < 0.01) and PTPes by 57% (P < 0.001). A non-significant trend for decrease in PaCO(2) was observed.

Conclusion: In these infants, non-invasive pressure support ventilation with turbine flow generator induced a reduction of breathing frequency, dPes and PTPes, indicating reduced load of the inspiratory muscles. NIV can be used with some benefits in infants with respiratory failure after extubation.

MeSH terms

  • Continuous Positive Airway Pressure*
  • Feasibility Studies
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Intubation, Intratracheal*
  • Male
  • Pilot Projects
  • Prospective Studies
  • Respiratory Insufficiency / therapy*