Ventilation non invasive chez l'enfant : mise en place en urgence

In children, non-invasive ventilation (NIV) is now commonly selected as a first-line treatment for respiratory distress management. The objective is to prevent respiratory exhaustion and recourse to invasive ventilation, which requires an early use of NIV, and a relevant selection of NIV mode according to respiratory distress type. Recent technical advances in interfaces and respirators allow an easier implementation, thanks to improved compensation for leaks and patient-ventilator interaction. Some indications are supported by evidence, including viral bronchiolitis, with a very low failure rate. Others are associated with a high failure rate, such as acute respiratory distress syndrome (ARDS), inciting a very prudent use by expert teams. Potential indications, such as severe asthmatic attack or weaning from invasive ventilation, require further evaluation in clinical trials. The dissemination of theoretical and practical trainings, supported by the European Society of Paediatric and Neonatal Intensive Care (ESPNIC), should allow to standardize and secure this growing practice.