A novel technique of non-invasive ventilation: Pharyngeal oxygen with nose-closure and abdominal-compressionAid for pediatric flexible bronchoscopy

作者：Soong Wen Jue^*; Jeng Mei Jy; Lee Yu Sheng; Tsao Pei Chen; Harloff Morgan; Matthew Soong Yen Hui

来源：Pediatric Pulmonology, 2015, 50(6): 568-575.

DOI：10.1002/ppul.23028

• abdominal compression
• therapeutic flexible bronchoscopy
• non-invasive ventilation
• nose-closure ventilation
• positive pressure ventilation
• resuscitation

ObjectiveTo evaluate the safety, feasibility and efficacy of a novel non-invasive ventilation (NIV) techniquepharyngeal oxygen with nose-closure and abdominal-compression (PhO2-NC-AC)to aid pediatric flexible bronchoscopy (FB).
DesignA prospective 1 year study of patients who received FB. A basic PhO2 flow (0.5-1.0L/kg/min, maximal 5.0L/min) was routinely applied. Active NIV was initiated when the heart rate dropped <80beats/min or desaturation was <80% for >10sec. It was performed as follows: NC 1sec for inspiration then released, followed by AC 1sec for active expiration at a rate of 20-30cycles/min until vital signs returned to acceptable levels for >10sec. When the patients were stable, supplementary NIV was optionally given. Cardiopulmonary parameters were collected and analyzed.
Measurements and Main ResultsThree hundred thirty-seven FBs, including 188 therapeutic, were conducted in 286 patients with a mean age of 18.3 months (14.4, 10min to 12 years) and a mean body weight of 13.5kg (+/- 6.7, 0.5-35kg). Three hundred thirty-three active NIVs were executed with a mean duration of 87.8sec (+/- 40.4, 28-190sec). A significantly longer FB duration (33.2 +/- 16.7min vs. 7.2 +/- 2.8min, P<0.001) and a higher application rate of active NIV (1.44/FB vs. 0.42/FB) were noted in the therapeutic compared to the diagnostic group. Vital signs and blood gases (35 cases) improved rapidly and returned to baseline within 3min. All FBs were safely and successfully completed without significant complications.
ConclusionsPhO(2)-NC-AC is a simple, safe and effective NIV technique for respiratory support and rescue during various pediatric FB procedures. Pediatr Pulmonol. 2015; 50:568-575.

• 出版日期2015-6