Comparing the effectiveness of using BiPAP and CPAP for successful weaning from the ventilator in children with underlying neurological problems admitted to the PICU

Knowledge of effectiveness of using BiPAP for successful weaning in children with underlying neurological problems admitted to the PICU of Motahari hospital can be helpful in patient management.

Two arm parallel group randomised trial

As pilot,12 intubated patients, admitted to the PICU with underlying neurological disease will be included in each arm of the study. Randomization will be performed using Random Number Generation software. Inclusion criteria include intubation and underlying neurological disease, and exclusion criteria include having other associated underlying diseases. patients After meeting the conditions for weaning, such as consciousness and spontaneous breathing and the need for a low percentage of oxygen, weaning from the ventilator and immediately undergoing assisted breathing, Bilevel Positive Airway Pressure (BiPAP) or Continuous Positive Airway Pressure(CPAP) and were monitored for respiratory status for the next 72 hours.They are evaluated for the need of reintubation, and if there is no need for reintubation within 72 hours of extubation, the separation considered successful. Also duration of hospitalization of patients in two groups, as well as the associated complications, are evaluated. The rate of successful weaning considered as primary outcome and the duration of hospitalization and complications as the secondary outcome.

Inclusion: Intubation and having underlying neurological disease. Exclusion: Having other underlying diseases such as heart disease.

Patients aged 1 month to 18 years who have underlying neurological disease and admitted to the PICU and are intubated. Of these, randomly 12 individuals will be placed under BiPAP after extubation and 12 randomly selected individuals will be placed under NCPAP. BiPAP , CPAP

Successful weaning

Randomization will be performed using Random Number Generation software. Random generator is a simple software for generating random numbers between two specified numbers, where the discrete numbers are from 1 to 24 and each patient is identified by a number. First, the software randomly selects 12 numbers from 1 to 24, which are assigned to 12 intubated patients with underlying neurological problems and will be placed on BiPAP. The remaining 12 numbers from 1 to 24 will be assigned to other intubated patients with neurological problems and will be placed on CPAP. Now, patients are assigned numbers one to 24 in order of admission and are put on BiPAP or CPAP. For example, initially according to the software, we have 12 numbers that are supposed to be put on BiPAP, for example, numbers 3,4,7,11,13,14,... Now, the first patient with the entry criteria will be number one and will be put on CPAP. The next patient is assigned number 2 and is put on CPAP. The next patient is assigned number 3 and is put on BiPAP, and so on, up to 24 patients.

Successful extubation rate

1 Mon

Mohammad Salavatizade, Mohammad Valizade, Babak Hasanlooyi, Tohid Ebadi

After statistical analysis

Tohid Ebadi

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