The Experts below are selected from a list of 4434 Experts worldwide ranked by ideXlab platform
Christophe Milesi - One of the best experts on this subject based on the ideXlab platform.
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assessment of peak inspiratory flow in young infants with acute Viral Bronchiolitis physiological basis for initial flow setting in patients supported with high flow nasal cannula
2021Co-Authors: Christophe Milesi, Anne Requirand, Aymeric Douillard, Julien Baleine, Erika Nogue, S Matecki, Pascal Amedro, Marti Ponsodena, Gilles CambonieAbstract:Objective To assess the inspiratory demand in young infants with acute Viral Bronchiolitis to provide a physiological basis for initial flow setting for patients supported with high flow nasal cannula. Study design Prospective study in 44 infants up to 6 months old with acute Viral Bronchiolitis, admitted to a pediatric intensive care unit from November 2017 to March 2019. Airflow measurements were performed using spirometry. The primary endpoint was the inspiratory demand as measured by peak tidal inspiratory flow (PTIF). The secondary endpoints were the relationships determined between PTIF, patient weight, and disease severity. Results Median (Q25-Q75) age and weight of the patients were 37 (20-67) days and 4.3 (3.5-5.0) kg, respectively. Mean PTIF was 7.45 (95% CI 6.51-8.39, min-max: 2.40-16.00) L/minute. PTIF indexed to weight was 1.68 (95% CI 1.51-1.85, min-max: 0.67-3.00) L/kg/minute. PTIF was Conclusions High flow nasal cannula therapy is used commonly to support infants with acute Viral Bronchiolitis. The efficiency of the device is optimal if the flow setting matches the patient's inspiratory demand. According to our results, a flow rate of
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assessment of peak inspiratory flow in young infants with acute Viral Bronchiolitis physiological basis for initial flow setting in patients supported with high flow nasal cannula
2020Co-Authors: Christophe Milesi, Anne Requirand, Aymeric Douillard, Julien Baleine, Erika Nogue, S Matecki, Pascal Amedro, Marti Ponsodena, Gilles CambonieAbstract:Objective To assess the inspiratory demand in young infants with acute Viral Bronchiolitis, in order to provide a physiological basis for initial flow setting for patients supported with high flow nasal cannula (HFNC). Study design Prospective study in 44 infants up to 6 months old with AVB, admitted to a pediatric intensive care unit from November 2017 to March 2019. Airflow measurements were performed using spirometry. The primary endpoint was the inspiratory demand as measured by peak tidal inspiratory flow (PTIF). The secondary endpoints were the relationships determined between PTIF, patient weight, and disease severity. Results Median (Q25-Q75) age and weight of the patients were, respectively, 37 (20-67) days and 4.3 (3.5-5.0) kg. Mean PTIF was 7.45 (95% CI: 6.51-8.39, min-max: 2.40-16.00) L/min. PTIF indexed to weight was 1.68 (95% CI: 1.51-1.85, min-max: 0.67-3.00) L/kg/min. PTIF was Conclusions HFNC therapy is commonly used to support infants with AVB. The efficiency of the device is optimal if the flow setting matches the patient’s inspiratory demand. According to our results, a flow rate
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a multicenter randomized controlled trial of a 3 l kg min versus 2 l kg min high flow nasal cannula flow rate in young infants with severe Viral Bronchiolitis tramontane 2
2018Co-Authors: Christophe Milesi, Robin Pouyau, Jeanmichel Liet, Anneflorence Pierre, Anna Deho, Camille Guillot, Annesophie Guilbert, Jerome Rambaud, Astrid Millet, Mickael AfanettiAbstract:High-flow nasal cannula (HFNC) therapy is increasingly proposed as first-line respiratory support for infants with acute Viral Bronchiolitis (AVB). Most teams use 2 L/kg/min, but no study compared different flow rates in this setting. We hypothesized that 3 L/kg/min would be more efficient for the initial management of these patients.
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high flow nasal cannula hfnc versus nasal continuous positive airway pressure ncpap for the initial respiratory management of acute Viral Bronchiolitis in young infants a multicenter randomized controlled trial tramontane study
2017Co-Authors: Christophe Milesi, Sandrine Essouri, Julien Baleine, Robin Pouyau, Jeanmichel Liet, Mickael Afanetti, Aurelie Portefaix, Sabine Durand, Clementine Combes, Aymeric DouillardAbstract:Purpose Nasal continuous positive airway pressure (nCPAP) is currently the gold standard for respiratory support for moderate to severe acute Viral Bronchiolitis (AVB). Although oxygen delivery via high flow nasal cannula (HFNC) is increasingly used, evidence of its efficacy and safety is lacking in infants.
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high flow nasal cannula hfnc versus nasal continuous positive airway pressure ncpap for the initial respiratory management of acute Viral Bronchiolitis in young infants a multicenter randomized controlled trial tramontane study
2017Co-Authors: Christophe Milesi, Sandrine Essouri, Julien Baleine, Robin Pouyau, Jeanmichel Liet, Mickael Afanetti, Aurelie Portefaix, Sabine Durand, Clementine Combes, Aymeric DouillardAbstract:Nasal continuous positive airway pressure (nCPAP) is currently the gold standard for respiratory support for moderate to severe acute Viral Bronchiolitis (AVB). Although oxygen delivery via high flow nasal cannula (HFNC) is increasingly used, evidence of its efficacy and safety is lacking in infants. A randomized controlled trial was performed in five pediatric intensive care units (PICUs) to compare 7 cmH2O nCPAP with 2 L/kg/min oxygen therapy administered with HFNC in infants up to 6 months old with moderate to severe AVB. The primary endpoint was the percentage of failure within 24 h of randomization using prespecified criteria. To satisfy noninferiority, the failure rate of HFNC had to lie within 15% of the failure rate of nCPAP. Secondary outcomes included success rate after crossover, intubation rate, length of stay, and serious adverse events. From November 2014 to March 2015, 142 infants were included and equally distributed into groups. The risk difference of −19% (95% CI −35 to −3%) did not allow the conclusion of HFNC noninferiority (p = 0.707). Superiority analysis suggested a relative risk of success 1.63 (95% CI 1.02–2.63) higher with nCPAP. The success rate with the alternative respiratory support, intubation rate, durations of noninvasive and invasive ventilation, skin lesions, and length of PICU stay were comparable between groups. No patient had air leak syndrome or died. In young infants with moderate to severe AVB, initial management with HFNC did not have a failure rate similar to that of nCPAP. This clinical trial was recorded in the National Library of Medicine registry (NCT 02457013).
Aymeric Douillard - One of the best experts on this subject based on the ideXlab platform.
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assessment of peak inspiratory flow in young infants with acute Viral Bronchiolitis physiological basis for initial flow setting in patients supported with high flow nasal cannula
2021Co-Authors: Christophe Milesi, Anne Requirand, Aymeric Douillard, Julien Baleine, Erika Nogue, S Matecki, Pascal Amedro, Marti Ponsodena, Gilles CambonieAbstract:Objective To assess the inspiratory demand in young infants with acute Viral Bronchiolitis to provide a physiological basis for initial flow setting for patients supported with high flow nasal cannula. Study design Prospective study in 44 infants up to 6 months old with acute Viral Bronchiolitis, admitted to a pediatric intensive care unit from November 2017 to March 2019. Airflow measurements were performed using spirometry. The primary endpoint was the inspiratory demand as measured by peak tidal inspiratory flow (PTIF). The secondary endpoints were the relationships determined between PTIF, patient weight, and disease severity. Results Median (Q25-Q75) age and weight of the patients were 37 (20-67) days and 4.3 (3.5-5.0) kg, respectively. Mean PTIF was 7.45 (95% CI 6.51-8.39, min-max: 2.40-16.00) L/minute. PTIF indexed to weight was 1.68 (95% CI 1.51-1.85, min-max: 0.67-3.00) L/kg/minute. PTIF was Conclusions High flow nasal cannula therapy is used commonly to support infants with acute Viral Bronchiolitis. The efficiency of the device is optimal if the flow setting matches the patient's inspiratory demand. According to our results, a flow rate of
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assessment of peak inspiratory flow in young infants with acute Viral Bronchiolitis physiological basis for initial flow setting in patients supported with high flow nasal cannula
2020Co-Authors: Christophe Milesi, Anne Requirand, Aymeric Douillard, Julien Baleine, Erika Nogue, S Matecki, Pascal Amedro, Marti Ponsodena, Gilles CambonieAbstract:Objective To assess the inspiratory demand in young infants with acute Viral Bronchiolitis, in order to provide a physiological basis for initial flow setting for patients supported with high flow nasal cannula (HFNC). Study design Prospective study in 44 infants up to 6 months old with AVB, admitted to a pediatric intensive care unit from November 2017 to March 2019. Airflow measurements were performed using spirometry. The primary endpoint was the inspiratory demand as measured by peak tidal inspiratory flow (PTIF). The secondary endpoints were the relationships determined between PTIF, patient weight, and disease severity. Results Median (Q25-Q75) age and weight of the patients were, respectively, 37 (20-67) days and 4.3 (3.5-5.0) kg. Mean PTIF was 7.45 (95% CI: 6.51-8.39, min-max: 2.40-16.00) L/min. PTIF indexed to weight was 1.68 (95% CI: 1.51-1.85, min-max: 0.67-3.00) L/kg/min. PTIF was Conclusions HFNC therapy is commonly used to support infants with AVB. The efficiency of the device is optimal if the flow setting matches the patient’s inspiratory demand. According to our results, a flow rate
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high flow nasal cannula hfnc versus nasal continuous positive airway pressure ncpap for the initial respiratory management of acute Viral Bronchiolitis in young infants a multicenter randomized controlled trial tramontane study
2017Co-Authors: Christophe Milesi, Sandrine Essouri, Julien Baleine, Robin Pouyau, Jeanmichel Liet, Mickael Afanetti, Aurelie Portefaix, Sabine Durand, Clementine Combes, Aymeric DouillardAbstract:Purpose Nasal continuous positive airway pressure (nCPAP) is currently the gold standard for respiratory support for moderate to severe acute Viral Bronchiolitis (AVB). Although oxygen delivery via high flow nasal cannula (HFNC) is increasingly used, evidence of its efficacy and safety is lacking in infants.
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high flow nasal cannula hfnc versus nasal continuous positive airway pressure ncpap for the initial respiratory management of acute Viral Bronchiolitis in young infants a multicenter randomized controlled trial tramontane study
2017Co-Authors: Christophe Milesi, Sandrine Essouri, Julien Baleine, Robin Pouyau, Jeanmichel Liet, Mickael Afanetti, Aurelie Portefaix, Sabine Durand, Clementine Combes, Aymeric DouillardAbstract:Nasal continuous positive airway pressure (nCPAP) is currently the gold standard for respiratory support for moderate to severe acute Viral Bronchiolitis (AVB). Although oxygen delivery via high flow nasal cannula (HFNC) is increasingly used, evidence of its efficacy and safety is lacking in infants. A randomized controlled trial was performed in five pediatric intensive care units (PICUs) to compare 7 cmH2O nCPAP with 2 L/kg/min oxygen therapy administered with HFNC in infants up to 6 months old with moderate to severe AVB. The primary endpoint was the percentage of failure within 24 h of randomization using prespecified criteria. To satisfy noninferiority, the failure rate of HFNC had to lie within 15% of the failure rate of nCPAP. Secondary outcomes included success rate after crossover, intubation rate, length of stay, and serious adverse events. From November 2014 to March 2015, 142 infants were included and equally distributed into groups. The risk difference of −19% (95% CI −35 to −3%) did not allow the conclusion of HFNC noninferiority (p = 0.707). Superiority analysis suggested a relative risk of success 1.63 (95% CI 1.02–2.63) higher with nCPAP. The success rate with the alternative respiratory support, intubation rate, durations of noninvasive and invasive ventilation, skin lesions, and length of PICU stay were comparable between groups. No patient had air leak syndrome or died. In young infants with moderate to severe AVB, initial management with HFNC did not have a failure rate similar to that of nCPAP. This clinical trial was recorded in the National Library of Medicine registry (NCT 02457013).
Mickael Afanetti - One of the best experts on this subject based on the ideXlab platform.
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a multicenter randomized controlled trial of a 3 l kg min versus 2 l kg min high flow nasal cannula flow rate in young infants with severe Viral Bronchiolitis tramontane 2
2018Co-Authors: Christophe Milesi, Robin Pouyau, Jeanmichel Liet, Anneflorence Pierre, Anna Deho, Camille Guillot, Annesophie Guilbert, Jerome Rambaud, Astrid Millet, Mickael AfanettiAbstract:High-flow nasal cannula (HFNC) therapy is increasingly proposed as first-line respiratory support for infants with acute Viral Bronchiolitis (AVB). Most teams use 2 L/kg/min, but no study compared different flow rates in this setting. We hypothesized that 3 L/kg/min would be more efficient for the initial management of these patients.
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high flow nasal cannula hfnc versus nasal continuous positive airway pressure ncpap for the initial respiratory management of acute Viral Bronchiolitis in young infants a multicenter randomized controlled trial tramontane study
2017Co-Authors: Christophe Milesi, Sandrine Essouri, Julien Baleine, Robin Pouyau, Jeanmichel Liet, Mickael Afanetti, Aurelie Portefaix, Sabine Durand, Clementine Combes, Aymeric DouillardAbstract:Purpose Nasal continuous positive airway pressure (nCPAP) is currently the gold standard for respiratory support for moderate to severe acute Viral Bronchiolitis (AVB). Although oxygen delivery via high flow nasal cannula (HFNC) is increasingly used, evidence of its efficacy and safety is lacking in infants.
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high flow nasal cannula hfnc versus nasal continuous positive airway pressure ncpap for the initial respiratory management of acute Viral Bronchiolitis in young infants a multicenter randomized controlled trial tramontane study
2017Co-Authors: Christophe Milesi, Sandrine Essouri, Julien Baleine, Robin Pouyau, Jeanmichel Liet, Mickael Afanetti, Aurelie Portefaix, Sabine Durand, Clementine Combes, Aymeric DouillardAbstract:Nasal continuous positive airway pressure (nCPAP) is currently the gold standard for respiratory support for moderate to severe acute Viral Bronchiolitis (AVB). Although oxygen delivery via high flow nasal cannula (HFNC) is increasingly used, evidence of its efficacy and safety is lacking in infants. A randomized controlled trial was performed in five pediatric intensive care units (PICUs) to compare 7 cmH2O nCPAP with 2 L/kg/min oxygen therapy administered with HFNC in infants up to 6 months old with moderate to severe AVB. The primary endpoint was the percentage of failure within 24 h of randomization using prespecified criteria. To satisfy noninferiority, the failure rate of HFNC had to lie within 15% of the failure rate of nCPAP. Secondary outcomes included success rate after crossover, intubation rate, length of stay, and serious adverse events. From November 2014 to March 2015, 142 infants were included and equally distributed into groups. The risk difference of −19% (95% CI −35 to −3%) did not allow the conclusion of HFNC noninferiority (p = 0.707). Superiority analysis suggested a relative risk of success 1.63 (95% CI 1.02–2.63) higher with nCPAP. The success rate with the alternative respiratory support, intubation rate, durations of noninvasive and invasive ventilation, skin lesions, and length of PICU stay were comparable between groups. No patient had air leak syndrome or died. In young infants with moderate to severe AVB, initial management with HFNC did not have a failure rate similar to that of nCPAP. This clinical trial was recorded in the National Library of Medicine registry (NCT 02457013).
Julien Baleine - One of the best experts on this subject based on the ideXlab platform.
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assessment of peak inspiratory flow in young infants with acute Viral Bronchiolitis physiological basis for initial flow setting in patients supported with high flow nasal cannula
2021Co-Authors: Christophe Milesi, Anne Requirand, Aymeric Douillard, Julien Baleine, Erika Nogue, S Matecki, Pascal Amedro, Marti Ponsodena, Gilles CambonieAbstract:Objective To assess the inspiratory demand in young infants with acute Viral Bronchiolitis to provide a physiological basis for initial flow setting for patients supported with high flow nasal cannula. Study design Prospective study in 44 infants up to 6 months old with acute Viral Bronchiolitis, admitted to a pediatric intensive care unit from November 2017 to March 2019. Airflow measurements were performed using spirometry. The primary endpoint was the inspiratory demand as measured by peak tidal inspiratory flow (PTIF). The secondary endpoints were the relationships determined between PTIF, patient weight, and disease severity. Results Median (Q25-Q75) age and weight of the patients were 37 (20-67) days and 4.3 (3.5-5.0) kg, respectively. Mean PTIF was 7.45 (95% CI 6.51-8.39, min-max: 2.40-16.00) L/minute. PTIF indexed to weight was 1.68 (95% CI 1.51-1.85, min-max: 0.67-3.00) L/kg/minute. PTIF was Conclusions High flow nasal cannula therapy is used commonly to support infants with acute Viral Bronchiolitis. The efficiency of the device is optimal if the flow setting matches the patient's inspiratory demand. According to our results, a flow rate of
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assessment of peak inspiratory flow in young infants with acute Viral Bronchiolitis physiological basis for initial flow setting in patients supported with high flow nasal cannula
2020Co-Authors: Christophe Milesi, Anne Requirand, Aymeric Douillard, Julien Baleine, Erika Nogue, S Matecki, Pascal Amedro, Marti Ponsodena, Gilles CambonieAbstract:Objective To assess the inspiratory demand in young infants with acute Viral Bronchiolitis, in order to provide a physiological basis for initial flow setting for patients supported with high flow nasal cannula (HFNC). Study design Prospective study in 44 infants up to 6 months old with AVB, admitted to a pediatric intensive care unit from November 2017 to March 2019. Airflow measurements were performed using spirometry. The primary endpoint was the inspiratory demand as measured by peak tidal inspiratory flow (PTIF). The secondary endpoints were the relationships determined between PTIF, patient weight, and disease severity. Results Median (Q25-Q75) age and weight of the patients were, respectively, 37 (20-67) days and 4.3 (3.5-5.0) kg. Mean PTIF was 7.45 (95% CI: 6.51-8.39, min-max: 2.40-16.00) L/min. PTIF indexed to weight was 1.68 (95% CI: 1.51-1.85, min-max: 0.67-3.00) L/kg/min. PTIF was Conclusions HFNC therapy is commonly used to support infants with AVB. The efficiency of the device is optimal if the flow setting matches the patient’s inspiratory demand. According to our results, a flow rate
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high flow nasal cannula hfnc versus nasal continuous positive airway pressure ncpap for the initial respiratory management of acute Viral Bronchiolitis in young infants a multicenter randomized controlled trial tramontane study
2017Co-Authors: Christophe Milesi, Sandrine Essouri, Julien Baleine, Robin Pouyau, Jeanmichel Liet, Mickael Afanetti, Aurelie Portefaix, Sabine Durand, Clementine Combes, Aymeric DouillardAbstract:Purpose Nasal continuous positive airway pressure (nCPAP) is currently the gold standard for respiratory support for moderate to severe acute Viral Bronchiolitis (AVB). Although oxygen delivery via high flow nasal cannula (HFNC) is increasingly used, evidence of its efficacy and safety is lacking in infants.
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high flow nasal cannula hfnc versus nasal continuous positive airway pressure ncpap for the initial respiratory management of acute Viral Bronchiolitis in young infants a multicenter randomized controlled trial tramontane study
2017Co-Authors: Christophe Milesi, Sandrine Essouri, Julien Baleine, Robin Pouyau, Jeanmichel Liet, Mickael Afanetti, Aurelie Portefaix, Sabine Durand, Clementine Combes, Aymeric DouillardAbstract:Nasal continuous positive airway pressure (nCPAP) is currently the gold standard for respiratory support for moderate to severe acute Viral Bronchiolitis (AVB). Although oxygen delivery via high flow nasal cannula (HFNC) is increasingly used, evidence of its efficacy and safety is lacking in infants. A randomized controlled trial was performed in five pediatric intensive care units (PICUs) to compare 7 cmH2O nCPAP with 2 L/kg/min oxygen therapy administered with HFNC in infants up to 6 months old with moderate to severe AVB. The primary endpoint was the percentage of failure within 24 h of randomization using prespecified criteria. To satisfy noninferiority, the failure rate of HFNC had to lie within 15% of the failure rate of nCPAP. Secondary outcomes included success rate after crossover, intubation rate, length of stay, and serious adverse events. From November 2014 to March 2015, 142 infants were included and equally distributed into groups. The risk difference of −19% (95% CI −35 to −3%) did not allow the conclusion of HFNC noninferiority (p = 0.707). Superiority analysis suggested a relative risk of success 1.63 (95% CI 1.02–2.63) higher with nCPAP. The success rate with the alternative respiratory support, intubation rate, durations of noninvasive and invasive ventilation, skin lesions, and length of PICU stay were comparable between groups. No patient had air leak syndrome or died. In young infants with moderate to severe AVB, initial management with HFNC did not have a failure rate similar to that of nCPAP. This clinical trial was recorded in the National Library of Medicine registry (NCT 02457013).
Sandrine Essouri - One of the best experts on this subject based on the ideXlab platform.
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Optimal level of nasal continuous positive airway pressure in severe Viral Bronchiolitis
2020Co-Authors: Sandrine Essouri, Philippe Durand, Laurent Chevret, Laurent Balu, Denis Devictor, Brigitte Fauroux, Pierre Tissieres, Á P Durand, Á L ChevretAbstract:Abstract Purpose: To determine the optimal level of nasal continuous positive airway pressure (nCPAP) in infants with severe hypercapnic Viral Bronchiolitis as assessed by the maximal unloading of the respiratory muscles and improvement of breathing pattern and gas exchange. Methods: A prospective physiological study in a tertiary paediatric intensive care unit (PICU). Breathing pattern, gas exchange, intrinsic end expiratory pressure (PEEPi) and respiratory muscle effort were measured in ten infants with severe hypercapnic Viral Bronchiolitis during spontaneous breathing (SB) and three increasing levels of nCPAP. Results: During SB, median PEEPi was 6 cmH 2 O (range 3.9-9.2 cmH 2 O), median respiratory rate was 78 breaths/min (range 41-96), median inspiratory time/total duty cycle (T i /T tot ) was 0.45 (range 0.40-0.48) and transcutaneous carbon dioxide pressure (P tc CO 2 ) was 61.5 mmHg (range 50-78). In all the infants, an nCPAP level of 7 cmH 2 O was associated with the greatest reduction in respiratory effort with a mean reduction in oesophageal and diaphragmatic pressure swings of 48 and 46%, respectively, and of the oesophageal and diaphragmatic pressure time product of 49 and 56%, respectively. During nCPAP, median respiratory rate decreased to 56 breaths/min (range 39-108, p \ 0.05), median T i /T tot decreased to 0.40 (range 0.34-0.44, p \ 0.50) and P tc CO 2 decreased to 49 mmHg (range 35-65, p \ 0.05). Only one infant with associated bacterial pneumonia required intubation and all the infants were discharged alive from the PICU after a median stay of 5.5 (range 3-27 days). Conclusion: In infants with hypercapnic respiratory failure due to acute Viral Bronchiolitis, an nCPAP level of 7 cmH 2 O is associated with the greatest unloading of the respiratory muscles and improvement of breathing pattern, as well as a favourable short-term clinical outcome. Keywords Nasal continuous positive airway pressure Á Intrinsic positive end expiratory pressure Á Bronchiolitis Á Work of breathing Á Childre
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high flow nasal cannula hfnc versus nasal continuous positive airway pressure ncpap for the initial respiratory management of acute Viral Bronchiolitis in young infants a multicenter randomized controlled trial tramontane study
2017Co-Authors: Christophe Milesi, Sandrine Essouri, Julien Baleine, Robin Pouyau, Jeanmichel Liet, Mickael Afanetti, Aurelie Portefaix, Sabine Durand, Clementine Combes, Aymeric DouillardAbstract:Purpose Nasal continuous positive airway pressure (nCPAP) is currently the gold standard for respiratory support for moderate to severe acute Viral Bronchiolitis (AVB). Although oxygen delivery via high flow nasal cannula (HFNC) is increasingly used, evidence of its efficacy and safety is lacking in infants.
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high flow nasal cannula hfnc versus nasal continuous positive airway pressure ncpap for the initial respiratory management of acute Viral Bronchiolitis in young infants a multicenter randomized controlled trial tramontane study
2017Co-Authors: Christophe Milesi, Sandrine Essouri, Julien Baleine, Robin Pouyau, Jeanmichel Liet, Mickael Afanetti, Aurelie Portefaix, Sabine Durand, Clementine Combes, Aymeric DouillardAbstract:Nasal continuous positive airway pressure (nCPAP) is currently the gold standard for respiratory support for moderate to severe acute Viral Bronchiolitis (AVB). Although oxygen delivery via high flow nasal cannula (HFNC) is increasingly used, evidence of its efficacy and safety is lacking in infants. A randomized controlled trial was performed in five pediatric intensive care units (PICUs) to compare 7 cmH2O nCPAP with 2 L/kg/min oxygen therapy administered with HFNC in infants up to 6 months old with moderate to severe AVB. The primary endpoint was the percentage of failure within 24 h of randomization using prespecified criteria. To satisfy noninferiority, the failure rate of HFNC had to lie within 15% of the failure rate of nCPAP. Secondary outcomes included success rate after crossover, intubation rate, length of stay, and serious adverse events. From November 2014 to March 2015, 142 infants were included and equally distributed into groups. The risk difference of −19% (95% CI −35 to −3%) did not allow the conclusion of HFNC noninferiority (p = 0.707). Superiority analysis suggested a relative risk of success 1.63 (95% CI 1.02–2.63) higher with nCPAP. The success rate with the alternative respiratory support, intubation rate, durations of noninvasive and invasive ventilation, skin lesions, and length of PICU stay were comparable between groups. No patient had air leak syndrome or died. In young infants with moderate to severe AVB, initial management with HFNC did not have a failure rate similar to that of nCPAP. This clinical trial was recorded in the National Library of Medicine registry (NCT 02457013).
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optimal level of nasal continuous positive airway pressure in severe Viral Bronchiolitis
2011Co-Authors: Sandrine Essouri, Philippe Durand, Laurent Chevret, Laurent Balu, Denis Devictor, Brigitte Fauroux, Pierre TissieresAbstract:Purpose To determine the optimal level of nasal continuous positive airway pressure (nCPAP) in infants with severe hypercapnic Viral Bronchiolitis as assessed by the maximal unloading of the respiratory muscles and improvement of breathing pattern and gas exchange.
