Corbisier Tiphaine, Cousin Vladimir L, Polito Angelo, Bordessoule Alice
Pediatric and Neonatal Intensive Care Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospital of Geneva, University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1206, Geneva, Switzerland.
Eur J Pediatr. 2025 May 29;184(6):369. doi: 10.1007/s00431-025-06198-2.
Bronchiolitis is a major cause of respiratory failure in infants, necessitating non-invasive ventilation (NIV). While total face masks (TFM) are an alternative to nasal interfaces for NIV, they pose unique challenges for enteral feeding due to their design, which can limit airway access and increase the risk of complications. This study aimed to investigate the feeding practices of pediatric intensivists managing bronchiolitis patients using TFM for NIV. A cross-sectional survey (SurveyMonkey® software (San Matteo, California, USA)) was conducted among pediatric intensivists in the Groupe Francophone de Réanimation et d'Urgences Pédiatrique (GFRUP) across four French-speaking countries. The survey, consisting of 11 multiple-choice questions, assessed clinical practices related to TFM use and enteral feeding, including initiation timing, feeding methods, and associated complications. From January 2024 to April 2024, 33 intensivists from 10 units and 4 countries (France, Switzerland, Belgium, Canada) answered the survey. All physicians used routinely TFM with 40% of them using it as a first-line NIV interface. Enteral feeding was commonly initiated within 6 h of TFM initiation, with 72% of clinicians waiting for a stabilization period of 3 to 6 h. The majority (85%) employed gastric feeding, with a low incidence of severe complications reported. Vomiting was the most frequent issue, while aspiration pneumonia was rare.
Despite the challenges associated with TFM, enteral feeding is widely practiced among pediatric intensivists, with a cautious approach to initiation and a low complication rate. These findings highlight the need for individualized feeding strategies and further research to optimize feeding practices in this population.
• Total face masks (TFM) are increasingly used as an alternative to nasal or naso-buccal interfaces for non invasive ventilation in children. TFM may complicate enteral feeding with limited data available on feeding partances and related complications in this context.
• This multicountry survey reveals taht enteral feeding is commonly implemented in children receiving non invasive ventilation via TFM, typically initiated early after clinical stabilization. The low incidence of severe complications supports the overall safety of this approach when applied with caution.
细支气管炎是婴儿呼吸衰竭的主要原因，需要无创通气（NIV）。虽然全脸面罩（TFM）是NIV鼻接口的一种替代方案，但由于其设计，在肠内喂养方面带来了独特挑战，这可能会限制气道通路并增加并发症风险。本研究旨在调查使用TFM进行NIV治疗细支气管炎患者的儿科重症监护医生的喂养实践。在四个法语国家的法语儿科复苏与急诊小组（GFRUP）的儿科重症监护医生中进行了一项横断面调查（使用SurveyMonkey®软件（美国加利福尼亚州圣马特奥））。该调查由11个多项选择题组成，评估了与TFM使用和肠内喂养相关的临床实践，包括开始时间、喂养方法和相关并发症。2024年1月至2024年4月，来自10个单位和4个国家（法国、瑞士、比利时、加拿大）的33名重症监护医生回答了该调查。所有医生都常规使用TFM，其中40%将其用作一线NIV接口。肠内喂养通常在TFM开始使用后的6小时内开始，72%的临床医生会等待3至6小时的稳定期。大多数（85%）采用胃内喂养，报告的严重并发症发生率较低。呕吐是最常见的问题，而吸入性肺炎很少见。
尽管TFM存在相关挑战，但肠内喂养在儿科重症监护医生中广泛应用，开始时采取谨慎态度且并发症发生率较低。这些发现凸显了针对该人群制定个性化喂养策略以及进一步研究以优化喂养实践的必要性。
• 全脸面罩（TFM）越来越多地被用作儿童无创通气鼻或鼻颊接口的替代方案。在这种情况下，关于喂养方式和相关并发症的数据有限，TFM可能会使肠内喂养复杂化。
• 这项多国调查显示，在通过TFM接受无创通气的儿童中，肠内喂养普遍实施，通常在临床稳定后早期开始。严重并发症发生率低支持了谨慎应用这种方法时的总体安全性。
