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Weaning of children with burn injury by noninvasive ventilation (NIV): a clinical experience.

The aim of this study was to report the respiratory management of a cohort of infants admitted to Pediatric Intensive Care Unit (PICU) over a 7-year period due to severe burn injury. A retrospective review of all pediatric patients admitted to PICU between 2009 and 2016 was conducted. From 2009 to 2016, 118 infants and children with burn injury were admitted to our institution (median age 16 months [IQR 12.2-20]); 51.7% of them had face burns, 37.3% underwent tracheal intubation and 30.5% had a PICU stay greater than 7 days. Ventilated patients had a longer PICU stay (13 days [IQR 8-26] vs 4.5 days [IQR 2-13]). Both ventilation requirement and TBSA% correlated with PICU stay (r 0.955, p<0.0001 and r 0.335, p 0.002, respectively), while ventilation was best related in those >1 week (r 0.964, p<0.0001 for ventilation, and r-0.079, p 0.680, for TBSA%). Noninvasive ventilation (NIV) was introduced in 10 patients, with the aim of shorten the invasive ventilation use. As evidenced in our work, respiratory support is frequently needed in burned children. Ventilation need is one of the main factors for PICU admission and length of stay. No difference was found in terms of PICU length of stay and invasive mechanical ventilation time between children who underwent NIV and children who did not, despite children who underwent NIV had a larger burn surface.