Outcome of Noninvasive Ventilation V/S Oxygen Therapy in Children with Congestive Heart Failure

Abstract

Background:-Children with congestive heart failure (CHF) often require significant respiratory support due to the challenging nature of treatment. The aim of this study was to investigate the differential outcomes between two respiratory support modalities for pediatric patients with CHF.

Methods:-A prospective, cross-sectional, single-masked, controlled study was conducted in the Paediatric Intensive Care Unit (PICU) in Kolkata, situated in a tertiary care center. Fifty children diagnosed with CHF were randomly assigned to receive oxygen via nasal non-invasive ventilation (NIV) or a face mask oxygen (FMO). The subjects, aged between three months and twelve years, were stratified by age. Respiratory and hemodynamic parameters were recorded at three intervals: baseline (initiation of therapy), one to two hours post-initiation, and four to six hours post-initiation. Data were analyzed using chi-square and single t-test methods.

Results:-The NIV group exhibited significantly higher pH, pCO2, pO2, and SpO2 levels during the four to six-hour period compared to the FMO group. Additionally, the NIV group demonstrated a lower heart rate (p=0.164). In instances where treatment was unsuccessful, the NIV group required intubation for an average of 57.67 hours, while the FMO group required intubation for 43.25 hours. The average duration of NIV therapy was 41.08 hours, compared to 46.87 hours for FMO therapy. Intubation was necessary in 20.0% of the NIV group and 46.7% of the FMO group (p = 0.028). Mortality rates decreased by 6.7% with NIV, compared to a 13.3% reduction with FMO.

Conclusion:-Compared to oxygen therapy with a face mask, non-invasive ventilation improved respiratory outcomes, reduced the need for intubation, and decreased mortality rates in pediatric patients with CHF. Further research is warranted to fully understand the long-term effects of these interventions.