Treatment of acute respiratory failure by prolonged non-invasive ventilation in a child.

PURPOSE: To evaluate the feasibility and the efficacy of non-invasive ventilation (NIV) by nasal mask in a paediatric patient.

CLINICAL FEATURES: A four-year-old girl with acute lymphocytic leukaemia (ALL L1, pre-pre B) complicated by acute respiratory failure was treated with NIV. ON admission she exhibited hyperpyrexia (40C), pancytopaenia and severe hypoxia with hypocapnia (PaO2 = 45 mmHg; PaCO2 = 28.2 mmHG; pH = 7.30; SpO2 = 76%; ABE = -7.3 mmol.L-1. With NIV, PaO2 improved (PaO2 = 78 +/- 8 mmHG; SpO2 = 86 +/- 2; PaCO2 = 39 +/- 2) throughout the first day. Treatment was continued for six days until the patient was discharged. No complications were recorded.

CONCLUSION

Non-invasive ventilation by nasal mask may represent a choice in the treatment of acute respiratory failure of parenchymal origin in paediatric haematological patients.