Emergency treatment and nursing of children with severe pneumonia complicated by heart failure and respiratory failure: 10 case reports

Li, Wanli; An, Xinjiang; Fu, Mingyu; Li, Chunli

Since the application of mechanical ventilation is prone to cause ventilator-related complications, to improve the successful rescue rate of children with severe pneumonia and shorten the course of treatment, the use of NCPAP may be considered a priority. For severe pneumonia, NCPAP can support cardiopulmonary function, and its early application can improve timely oxygenation, stabilize disease, prevent disease progression, reduce ventilator application and average hospitalization time in pediatric intensive care unit as well as avoid the adverse effects caused by intubation (34) . However, two points are important when applying it to infants: i) grasp indications and standard of respiratory failure that the children comply with; ii) over NCPAP application process, nasal and oral secretions should be immediately removed, raising the neck high, to strengthen expectoration in order to maintain airway patency. Operating parameters of using the NCPAP oxygen therapy machine in our department: i) Oxygen concentration inhaled (FiO2) 40 or 90%; ii) the oxygen flow 4-12 l/min; and iii) the beginning pressure was maintained at 3-4 cm H 2 O. After observing 2-4 h, the adjustment of pressure was determined by clinical symptoms, signs and blood gas analysis. NCPAP is an effective treatment for severe pneumonia with respiratory and heart failure, and can quickly correct hypoxemia, reduce endotracheal intubation and mechanical ventilation demand (35) . It has a positive effect and can reduce the stimulation of children, thus decreasing any occurrence of ventilator pneumonia. In addition, parents readily accepted this treatment (36) .