{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:44:04Z","timestamp":1791420244842,"version":"4.3.3"},"reference-count":21,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T00:00:00Z","timestamp":1721088000000},"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":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Respiratory failure in infants is a common reason for admission to the pediatric ICU (PICU). Although high-flow nasal cannula (HFNC) is the preferred first-line treatment at our institution, some infants require CPAP or noninvasive ventilation (NIV). Here we report our experience using CPAP\/NIV in infants &lt;10 kg.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a retrospective review of infants &lt;10 kg treated with CPAP\/NIV in our PICUs between July 2017\u2013May 2021 in the initial phase of treatment. Demographic, support type and settings, vital signs, pulse oximetry, and intubation data were extracted from the electronic health record. We compared subjects successfully treated with CPAP\/NIV with those who required intubation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We studied 62 subjects with median (interquartile range) age 96 [6.5\u2013308] d and weight 4.5 (3.4\u20136.6) kg. Of these, 22 (35%) required intubation. There were no significant differences in demographics, medical history, primary interface, pre-CPAP\/NIV support, and device used to deliver CPAP\/NIV. HFNC was used in 57 (92%) subjects before escalation to CPAP\/NIV. Subjects who failed CPAP\/NIV were less likely to have bronchiolitis (27% vs 60%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.040), less likely to be discharged from the hospital to home (68% vs 93%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.02), had a longer median hospital length of stay (LOS) (26.9 [21\u201350.5] d vs 10.4 [5.6\u201328.4] d,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.002), and longer median ICU LOS (14.6 [7.9\u201325.2] d vs 5.8 [3.8\u201312.4] d,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.004). Initial vital signs and F\n                      <jats:sub>\n                        IO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      were similar, but S\n                      <jats:sub>\n                        pO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      was lower and F\n                      <jats:sub>\n                        IO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      higher at 6 h and 12 h after support initiation for subjects who failed CPAP\/NIV. Initial CPAP\/NIV settings were similar, but subjects who failed CPAP\/NIV had higher maximum and final inspiratory\/expiratory pressure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      Most infants who failed initial HFNC support were successfully managed without intubation using NIV or CPAP. Bronchiolitis was associated with a lower rate of CPAP\/NIV failure, whereas lower S\n                      <jats:sub>\n                        pO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      and higher F\n                      <jats:sub>\n                        IO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      levels were associated with higher rates of intubation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.11935","type":"journal-article","created":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T09:35:24Z","timestamp":1721122524000},"page":"161-169","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Noninvasive Ventilation or CPAP in the Initial Treatment Phase of Small Infants With Respiratory Failure"],"prefix":"10.1177","volume":"70","author":[{"given":"Andrew G.","family":"Miller","sequence":"first","affiliation":[{"name":"Mr Miller is affiliated with Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina; and Respiratory Care Services, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karan R.","family":"Kumar","sequence":"additional","affiliation":[{"name":"Dr Kumar is affiliated with Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina; and Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhargav S.","family":"Adagarla","sequence":"additional","affiliation":[{"name":"Mr Adagarla is affiliated with Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlyn E.","family":"Haynes","sequence":"additional","affiliation":[{"name":"Mss Haynes, Gates, and Muddiman are affiliated with Respiratory Care Services, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel M.","family":"Gates","sequence":"additional","affiliation":[{"name":"Mss Haynes, Gates, and Muddiman are affiliated with Respiratory Care Services, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanette L.","family":"Muddiman","sequence":"additional","affiliation":[{"name":"Mss Haynes, Gates, and Muddiman are affiliated with Respiratory Care Services, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Travis S.","family":"Heath","sequence":"additional","affiliation":[{"name":"Dr Heath is affiliated with Department of Pharmacy, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veerajalandhar","family":"Allareddy","sequence":"additional","affiliation":[{"name":"Drs Allareddy and Rotta are affiliated with Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre T.","family":"Rotta","sequence":"additional","affiliation":[{"name":"Drs Allareddy and Rotta are affiliated with Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,7,16]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2022.02.004"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2022.12.010"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202204-0795SO"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1709656"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.9615"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-018-2080-3"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005210"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001798"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60249-5"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(19)30243-7"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000002808"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000003109"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25033"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/0885066620979642"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.11194"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.09018"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2020.3579"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-02988-4"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001226"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.09360"}],"container-title":["Respiratory 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