{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T19:23:56Z","timestamp":1782242636776,"version":"3.54.5"},"reference-count":15,"publisher":"Cambridge University Press (CUP)","issue":"12","license":[{"start":{"date-parts":[[2021,4,5]],"date-time":"2021-04-05T00:00:00Z","timestamp":1617580800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951121001062_as1\"><jats:title>Background:<\/jats:title><jats:p>Children with CHD carry an additional burden of pulmonary insufficiency, often necessitating prolonged ventilatory support, especially in the peri-operative phase. There has been an increase in the utilisation of non-invasive ventilatory support for these children. The objective of this study was to evaluate the utilisation, safety, and outcomes of RAM cannula as a tool for escalation and de-escalation of respiratory support in paediatric cardiac patients less than one year of age.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951121001062_as2\"><jats:title>Methods:<\/jats:title><jats:p>A single-centre retrospective cohort study of patients supported with RAM cannula.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951121001062_as3\"><jats:title>Results:<\/jats:title><jats:p>A total of 275 instances of RAM use were included in the study, 81.1% being post-operative. Patients were stratified into escalation and de-escalation cohorts based on the indication of non-invasive ventilation. The success rate of using RAM cannula was 69.5% overall, 66.1% in the escalation group, and 72.8% in the de-escalation group. At baseline, age at cardiac ICU admission &gt;30 days, FiO2 \u2264 40%, PaCO2 \u2264 50 mmHg; and after 12 hours of non-invasive ventilation support respiratory rate \u2264 60\/min, PaO2 \u2265 50 mmHg, PaCO2 \u2264 50 mmHg; and absence of worsening on follow-up chest X-ray predicted the success with a sensitivity of 95% in the logistic regression model. Successful support was associated with a significantly shorter unit stay.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951121001062_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>RAM cannula can be safely used to provide non-invasive support to infants in the cardiac ICU for escalation and de-escalation of respiratory support. Factors associated with success can be used to make decisions about candidacy and appropriate timing of non-invasive ventilation use to maximise effectiveness.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951121001062","type":"journal-article","created":{"date-parts":[[2021,4,5]],"date-time":"2021-04-05T13:56:49Z","timestamp":1617631009000},"page":"1907-1913","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["Utilisation of RAM cannula for non-invasive respiratory support for infants in the cardiac ICU"],"prefix":"10.1017","volume":"31","author":[{"given":"Ashish","family":"Saini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin O.","family":"Maher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8358-9783","authenticated-orcid":false,"given":"Shriprasad R.","family":"Deshpande","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2021,4,5]]},"reference":[{"key":"S1047951121001062_ref2","doi-asserted-by":"publisher","DOI":"10.5812\/cardiovascmed.30391"},{"key":"S1047951121001062_ref6","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199202000-00008"},{"key":"S1047951121001062_ref3","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-2573"},{"key":"S1047951121001062_ref12","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2014.929659"},{"key":"S1047951121001062_ref11","doi-asserted-by":"publisher","DOI":"10.1111\/1552-6909.12233"},{"key":"S1047951121001062_ref8","doi-asserted-by":"publisher","DOI":"10.1053\/jcrc.2002.36760"},{"key":"S1047951121001062_ref10","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001282"},{"key":"S1047951121001062_ref4","first-page":"24","article-title":"Non-invasive ventilation in paediatric critical care","volume":"20","author":"Morley","year":"2016","journal-title":"Paediatr Respir Rev"},{"key":"S1047951121001062_ref9","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-016-0334-x"},{"key":"S1047951121001062_ref14","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-013-0837-7"},{"key":"S1047951121001062_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12329-X"},{"key":"S1047951121001062_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2011.01.007"},{"key":"S1047951121001062_ref13","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05978"},{"key":"S1047951121001062_ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-012-0590-3"},{"key":"S1047951121001062_ref5","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2002.119064"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951121001062","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T15:12:16Z","timestamp":1644333136000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951121001062\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,5]]},"references-count":15,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["S1047951121001062"],"URL":"https:\/\/doi.org\/10.1017\/s1047951121001062","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,5]]},"assertion":[{"value":"\u00a9 The Author(s), 2021. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}