Department of Child Health, Royal Hospital, Muscat, Oman.
Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman.
Sultan Qaboos Univ Med J. 2020 Aug;20(3):e245-e250. doi: 10.18295/squmj.2020.20.03.002. Epub 2020 Oct 5.
Noninvasive ventilation (NIV) and high-flow nasal therapy (HFNCT) are first-line methods of treatment for children presenting with acute respiratory distress, with paediatric intensive care units (PICUs) providing an ideal environment for subsequent treatment monitoring. However, the availability of step-down units, where NIV and HFNCT can be safely utilised, has reduced the need for such patients to be admitted to PICUs, thereby leading to the better overall utilisation of critical care resources. In addition, NIV and HFNCT can also be used during transport instead of invasive ventilation, thus avoiding the complications associated with the latter approach. This review article examines the safety and applicability of these respiratory support approaches outside of paediatric intensive care as well as various factors associated with treatment success or failure.
无创通气（NIV）和高流量鼻导管通气（HFNCT）是治疗急性呼吸窘迫儿童的一线治疗方法，儿科重症监护病房（PICU）为后续治疗监测提供了理想的环境。然而，由于有了可以安全使用 NIV 和 HFNCT 的下调节单元，因此减少了此类患者入住 PICU 的必要性，从而更好地利用了重症监护资源。此外，NIV 和 HFNCT 也可在转运过程中使用，而不是采用有创通气，从而避免了后者方法相关的并发症。本文回顾了这些呼吸支持方法在儿科重症监护之外的安全性和适用性，以及与治疗成功或失败相关的各种因素。
