{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T08:13:19Z","timestamp":1788855199506,"version":"build-2803163510"},"reference-count":31,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T00:00:00Z","timestamp":1655164800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>It remains unknown if pediatric patients failing initial noninvasive ventilation (NIV) experience worse clinical outcomes than those successfully treated with NIV or those primarily intubated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>This was a single-center, retrospective review of patients admitted with acute respiratory failure to the University of Michigan pediatric intensive care or cardiothoracic ICUs and receiving NIV or invasive mechanical ventilation as first-line therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      One hundred seventy subjects met inclusion criteria and were enrolled: 65 NIV success, 55 NIV failure, and 50 invasive mechanical ventilation alone. Of those failing NIV, median time to intubation was 1.8 (interquartile range [IQR] &lt; 1\u20137) h. On multivariable regression, ICU-free days were significantly different between groups (NIV success: 22.9 \u00b1 6.9 d; NIV failure: 13.0\n                      <jats:underline>\u00b1<\/jats:underline>\n                      6.6 d; invasive ventilation: 12.5\n                      <jats:underline>\u00b1<\/jats:underline>\n                      6.9 d;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001 across all groups). Multivariable regression revealed no difference in ventilator-free days between NIV failure and invasive ventilation groups (15.4\n                      <jats:underline>\u00b1<\/jats:underline>\n                      10.1 d vs 15.9\n                      <jats:underline>\u00b1<\/jats:underline>\n                      9.7 d,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .71). Of 64 subjects (37.6%) meeting Pediatric Acute Lung Injury Consensus Conference pediatric ARDS criteria, only 14% were successfully treated with NIV. Ventilator-free days were similar between the NIV failure and invasive ventilation groups (11.6 vs 13.2 d,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .47). On multivariable analysis, ICU-free days were significantly different across pediatric ARDS groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001): NIV success: 20.8 + 31.7 d; NIV failure: 8.3 + 23.8 d; invasive alone: 8.9 + 23.9 d, yet no significant difference in ventilator-free days between those with NIV failure versus invasive alone (11.6 vs 13.2 d,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .47).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>We demonstrated that critically ill pediatric subjects unsuccessfully trialed on NIV did not experience increased ICU length of stay or fewer ventilator-free days when compared to those on invasive mechanical ventilation alone, including in the pediatric ARDS subgroup. Our findings are predicated on a median time to intubation of &lt; 2 h in the NIV failure group and the provision of adequate monitoring while on NIV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.09348","type":"journal-article","created":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T14:25:15Z","timestamp":1655216715000},"page":"956-966","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical Outcomes of Acute Respiratory Failure Associated With Noninvasive and Invasive Ventilation in a Pediatric ICU"],"prefix":"10.1177","volume":"67","author":[{"given":"James M","family":"Kyle","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Critical Care and Sedation Services, Tripler Army Medical Center, Honolulu, Hawaii."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie M","family":"Sturza","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Michigan, C.S. Mott Children\u2019s Hospital, Ann Arbor, Michigan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald E","family":"Dechert","sequence":"additional","affiliation":[{"name":"Pediatric Respiratory Care, University of Michigan, Ann Arbor, Michigan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph R","family":"Custer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, C.S. Mott Children\u2019s Hospital, Ann Arbor, Michigan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary K","family":"Dahmer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, C.S. Mott Children\u2019s Hospital, Ann Arbor, Michigan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas G","family":"Saba","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology, Department of Pediatrics, University of Michigan, C.S Mott Children\u2019s Hospital, Ann Arbor, Michigan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi R","family":"Flori","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, C.S. 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