P0408 / #1101: RISK FACTORS AND OUTCOMES OF CHILDREN WITH ACUTE RESPIRATORY FAILURE AND TREATED WITH NON-INVASIVE OR INVASIVE VENTILATION

Abstract

Aims & Objectives: To determine risk factors of non-invasive ventilation techniques (NIV) failure in children admitted with acute respiratory failure (ARF) and to compare their outcomes with children treated successfully or with invasive ventilation alone (IMV). Methods: Retrospective analysis within LARed Network ARF multicenter registry. We included all PICU encounters for ARF treated with high flow nasal cannula(HFNC), continuous or bilevel positive pressure ventilation (CPAP/BIPAP) or IMV alone between May 2017- October 2019. NIV failure was defined as need of IMV after a NIV device. Results: Of 4615 patients, we evaluated 3 groups: NIV failure (392); NIV success (3269); only IMV (954). As shown in figure 1, HFNC failure was 10.6% (248/2084), BiPAP 10.8% (140/1160) (p= 0.353), and CPAP failure was 27.3%; (75/200) (p<0.01). We found differences in age, admission diagnosis, viral or bacterial suspected infections and pim3%. After a mixed logistic regression model to adjust for center, NIV failure had higher rates of health acquired infections (HAI) and longer PICU length of stay compared to IMV alone or NIV success. Morbidity and mortality were lower in NIV success group (0.2 and 0.4%) compare to failures (4.8% each), but not compared to IMV alone (3.9 and 5.2%).Conclusions: In this multicenter study, NIV failure rate is low in children admitted to PICU for ARF. Younger age, suspected bacterial co-infection and admission diagnosis are risk factors for NIV failure. NIV failure has more HAIs and longer PICU LOS.