Noninvasive Respiratory Support

Noninvasive respiratory support is an important modality utilized in the pediatric critical care setting to treat respiratory failure without the use of an artificial airway. On today's discussion, pediatric critical care fellow, Dr. John-David Bruce joins pediatric hospitalist, Dr. Brynn Ehlers and Dr. Gene Fisher who is a pediatric intensivist that serves as the division chief of Pediatric Critical Care unit at the Children's Hospital of Georgia.

After listening to this podcast, learners should be able to: 

1. Recognize different types of noninvasive respiratory support
2. Have an understanding of basic settings involved in the different modes of noninvasive respiratory support
3. Discuss conditions that are most ideal for noninvasive respiratory support 
4. Recognize when it is necessary to escalate to a higher mode of respiratory support
5. Common complications of noninvasive respiratory support and how do you treat them.

FREE CME Credit (requires free sign-up):  https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19507 

References:

• Amin, R, & Arca, MJ. Feasibility of non-invasive neurally adjusted ventilator assist after congenital diaphragmatic hernia repair. Journal of Pediatric Surgery, 2019;54(3):434-438.
• Coletti, KD, Bagdure, DN, Walker, LK, Remy, KE, & Custer, JW. High-flow nasal cannula utilization in pediatric critical care. Respiratory Care, 2017;62(8):1023-1029.
• Desai, JP, & Moustarah, F. Pulmonary Compliance. StatPearls Publishing. 2021.  https://www.ncbi.nlm.nih.gov/books/NBK538324/
• Fedor, KL. Noninvasive respiratory support in infants and children. Respiratory Care, 2017;62(6):699-717.
  Franklin, D, Babl, FE, & Schlapbach, LJ, et al. A randomized trial of high-flow oxygen therapy in infants with bronchiolitis. The New England Journal of Medicine, 2018;378:1121-1131.
• Intagliata, S, Rizzo, A, & Gossman, WG. Physiology, Lung Dead Space. StatPearls Publishing. 2020. https://www.ncbi.nlm.nih.gov/books/NBK482501/
  Morrison, WE, Nelson McMillan, KL, & Shaffner, DH. (Eds.). Roger's Handbook of Pediatric Intensive Care (5th ed.). 2017. Wolters Kluwer.
• Najaf-Zadeh A, & Leclerc F. Noninvasive positive pressure ventilation for acute respiratory failure in children: a concise review. Ann Intensive Care. 2011;1(1):15. doi:10.1186/2110-5820-1-15
• Oymar, K, & Bardsen, K. Continuous positive airway pressure for bronchiolitis in a general paediatric ward; a feasibility study. BMC Pediatrics. 2014;14:122.
• Pope, JF, & Birnkrant, DJ. Noninvasive ventilation to facilitate extubation in a pediatric intensive care unit. Journal of Intensive Care Medicine. 2000;15(2):99-103. 
• Storre, JH, Bohm, P, Dreher, M, & Windisch, W. Clinical impact of leak compensation during non-invasive ventilation. Respiratory Medicine. 2009;103(10):1477-1483. 
• Silver AH, Nazif JM. Bronchiolitis. Pediatr Rev. 2019;40(11):568-576. doi:10.1542/pir.2018-0260