Noninvasive ventilation in pediatrics

Objective: To introduce the notion of noninvasive mechanical ventilation as an alternative for invasive ventilation in children, describing advantages and disadvantages, indications, and the process of equipment installation. Sources of data: Literature review through PubMed/Medline, using as source articles focusing on noninvasive ventilation in pediatric populations, as well as consensus statements and metanalyses concerning noninvasive ventilation in adults. Summary of the findings: The main indication for noninvasive ventilation is respiratory failure due to hypercapnia. It is contra-indicated in the presence of hemodynamic instability. The advantages of noninvasive ventilation include: the equipment is easy to install; it is not invasive and involves less discomfort; there is a lower incidence of complications associated with the endotracheal tube; lower cost. The disadvantages are: gastric distention; transient hypoxemia; facial skin necrosis. The equipment required for noninvasive ventilation includes an interface (mask) and a respirator. The removal of noninvasive ventilation equipment is relatively simple, but chronic patients may require assistance in the home. Conclusions: Noninvasive ventilation is a less costly, efficient and simple to perform alternative in cases of respiratory failure without hemodynamic instability.