Ventilation for pediatric patients

Noninvasive ventilation (NIV) has been used to treat sleep-disordered breathing, respiratory distress and respiratory failure in adults for decades, and its use in pediatric patients has grown significantly since the turn of the last century.

Respiratory failure in pediatric patients

Children are at increased risk of sleep-disordered breathing (SDB), respiratory distress or respiratory failure if they have:

Upper airway obstruction (caused by adenoid and tonsil hypertrophy, high arched palate, laryngomalcia and mircognathia)¹
Poor muscle tone (frequently associated with congenital conditions including muscular atrophies and dystrophies)¹

Lower airway obstruction or restriction (caused by bronchiectasis or scoliosis)¹
Poor functioning of the pons medulla (brain) and/or central nervous system (caused by congenial central hypoventilation syndrome or spinal cord injury)¹

If young children contract a respiratory infectious disease, they are also at risk of acute episodes of respiratory distress or respiratory failure, and may need respiratory support therapy during this time.

Treating pediatric respiratory failure

Resmed’s pediatric noninvasive ventilation (NIV) solutions are specifically engineered for young patients. With masks that are specially designed for children and ventilation devices that are FDA-cleared to treat pediatric patients weighing more than 30 lbs (>13 kg), Resmed’s pediatric ventilation options are suitable for the hospital and home.

Detecting a child’s tidal volume and/or respiratory effort requires sensitive algorithms and technology. Resmed has engineered respiratory support devices that offer advanced inspiratory trigger sensitivity, thereby improving synchrony and respiratory support for children and allowing clinicians to choose a high or very high sensitivity to make triggering easier.

To achieve adequate minute ventilation and/or patient synchrony, some children require an elevated respiratory rate. Resmed Stellar devices offer an adjustable back-up breath rate of up to 60 bpm. They also offer the Pressure Assist Control (PAC) mode, letting you set both a back-up rate and a fixed inspiratory time.

Unintentional leaks are inevitable, especially for pediatric patients who move frequently, or who don’t yet understand the need to keep the mask on. Resmed ventilators allow clinicians to set a “tight” Ti Max for pediatric patients to ensure that each breath terminates and cycles back into expiration, even in the presence of a large leak.

It’s important for families of children on NIV to participate in normal activities and excursions that promote bonding and quality of life. Resmed Stellar ventilators are equipped with an internal battery for extra mobility. Many Resmed ventilators can also accommodate the Resmed Power Station II (RPS II), which can provide from eight to sixteen hours of battery duration (based on whether one or two batteries are used).

The ideal system for treating pediatric respiratory conditions combines the Resmed Stellar™ ventilator, Pixi™ mask, H4i™ heated humidifier with SlimLine™ tubing, Resmed Power Station II (RPS II) and monitoring solutions.

References

Source: Cheifetz IM. Invasive and noninvasive pediatric mechanical ventilation. Respir Care. 2003 Apr;48(4):442-58