Caracterización de la ventilación mecánica no invasiva pediátrica hospitalaria

Background: Non-invasive mechanical ventilation (NIMV) has been established in the last decade in many Pediatric ICUs worldwide. However, several questions are still present about the real use of this therapy in our country. Objective: To describe the use of NIV in Chile in 2005. Method: A survey was sent by internet to all 43 Chilean PICU, in order to record some aspects like epidemiology, cause of hospitalization, human and material resources, technical parameters and complications regarding every patient ventilated with NIMV during 2005. Collected data was analyzed considering the overall sample and also separated by geographical regions (13 regions including the Metropolitan) and administrative issue (public or private centers). Results: 21 units answered the survey (49%), mostly (59%) from public hospitals in the Metropolitan Region. 4 centers did not use NIV in that period, all of them from provinces. This therapy was never instituted outside the ICU or High Dependency Unit (HDU). 68% of the units had this therapy since at least 2 years ago. 71% of the units provided NIMV up to 30 patients and 3 units ventilated between 100 and 400 patients in 2005. 71% answered that the average duration of NIV was 2-4 days. The most frequent diagnoses were asthma and pneumonia. The failure rate varied from < 1% to 50%. 55% of the units did not have defined criteria of institution or withdrawal of this ventilatory support and, also, 70% did not have a written guideline. Conclusion: We had a low response rate to the survey. At least 10% of all of the PICUs do not provide NIV in Chile. We found remarkable diversities among the different units regarding the number of treated patients, criteria of institution and withdrawal of NIMV, failure rate and absence of guidelines. The information obtained in this survey should be known and analyzed by health team members in order to ensure a more sensible and rigorous use of the NIMV.