Respiratory Modalities in Preventing Reintubation in a Pediatric Intensive Care Unit

• Published in: Global pediatric health Vol. 8; p. 2333794X21991531
• Main Authors: Al-Hadidi, Ameer, Lapkus, Morta, Karabon, Patrick, Akay, Begum, Khandhar, Paras
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 2021; Sage Publications Ltd; SAGE Publishing
• Subjects: Extubation; Intensive care; Original; Pediatrics; Respiratory failure; Ventilation; Ventilators; critical care; respiratory failure; reintubation; airway extubation; high-flow nasal cannula
• ISSN: 2333-794X; 2333-794X
• DOI: 10.1177/2333794X21991531

Post-extubation respiratory failure requiring reintubation in a Pediatric Intensive Care Unit (PICU) results in significant morbidity. Data in the pediatric population comparing various therapeutic respiratory modalities for avoiding reintubation is lacking. Our objective was to compare therapeutic respiratory modalities following extubation from mechanical ventilation. About 491 children admitted to a single-center PICU requiring mechanical ventilation from January 2010 through December 2017 were retrospectively reviewed. Therapeutic respiratory support assisted in avoiding reintubation in the majority of patients initially extubated to room air or nasal cannula with high-flow nasal cannula (80%) or noninvasive positive pressure ventilation (100%). Patients requiring therapeutic respiratory support had longer PICU LOS (10.92 vs 6.91 days, P-value = .0357) and hospital LOS (16.43 vs 10.20 days, P-value = .0250). Therapeutic respiratory support following extubation can assist in avoiding reintubation. Those who required therapeutic respiratory support experienced a significantly longer PICU and hospital LOS. Further prospective clinical trials are warranted.