Title: Predictors of Noninvasive Ventilation Failure in Children
題目：儿童无创通气失败的原因预测
Author 作者: Mimi Lu
 
Emergency physicians are often confronted with the child with acute respiratory failure.  Noninvasive ventilation (NIV) strategies such as continuous positive airway pressure (CPAP) and Bi-level positive airway pressure (BiPAP) can help support the child with reversible airway disease. Some children fail NIV and require endotracheal intubation and mechanical ventilation.
 
急诊医师经常会遇到急性呼吸衰竭的孩子。无创通气（NIV）如持续气道正压通气（CPAP），双期气道正压通气（BIPAP）的使用可以帮助支持可逆性气道疾病的孩子。有些孩子NIV无效，需要气管插管和机械通气。
 
 
Certain clinical markers have been shown to predict failure of NIV in the ICU setting.  Early identification of failure can reduce the delay to definitive therapy and may further reduce morbidity and mortality.
 
 在ICU情况下，有些简单的临床指标可以用来预测NIV失败的可能性。早期识别这些病人可以缩短进行确切治疗的时间，并可能进一步降低发病率和死亡率。

Simply checking the level of FiO2 one hour after starting NIV can predict failure.  In one prospective cohort, an FiO2 > 80% after one hour reasonably predicted need for intubation in patients with a variety of underlying respiratory pathology.  In contrast, the responder group had mean oxygen requirement of 48% FiO2.
 
只要检查开始NIV​​一小时后的所需给氧浓度（FIO2），就能够判断NIV失败者。在一个前瞻性的研究中，一小时后给氧浓度>80％可以合理的预测具有多种潜在的呼吸系统疾病病人需要插管 。与此相反，对照组的所需给氧浓度平均为48％。
 
References 参考文献:
Najaf-Zadeh A, Leclerc F. Noninvasive positive pressure ventilation for acute respiratory failure in children: a concise review. Annals of Intensive Care 2001, 1:15.
Bernet et al. Predictive factors for the success of noninvasive mask ventilation in infants and children with acute respiratory failure. Pediatr Crit Care Med 2005, 6:6.