Study finds, Early application of Non-invasive Ventilation f
The purpose of the present study was to investigate the effectiveness, oxygenation, requirement for invasive mechanical ventilation, and outcomes of children having pulmonary oedema following drowning, in clinical course of non-invasive ventilation (NIV).

Children referred by drowning-related pulmonary edema and NIV to the pediatric emergency service were included. There was documentation of demographics, vital signs, clinical findings and laboratory and radiological results. The Szpilman categorization system was used to categorize patients into 6 groups. Each patient has been documented the need for IMV, for the admission of a PICU, and for the duration of the NIV treatment and the stay at PICU.

--25 patients were enrolled. According to the Szpilman classification, 13 patients were evaluated as grade 3 and 12 as grade 4.

--All patients were treated with bi-level positive airway pressure in the spontaneous/timed mode.

--A significant increase in oxygen saturation (SpO2) and SpO2/fraction of inspired oxygen ratios was observed from the beginning of NIV treatment and this increase was also observed for the 2nd and 4th hours.

--There was a decrease in respiratory rate at the 4th hour of NIV treatment. No patient subsequently deteriorated to IMV.

In particular, a favorable clinical course of drowning patients who underwent early use of NIV in the pediatric emergency department were reported. Management of drowning patients with pulmonary edema by NIV with close follow-up can be successfully applied in selected cases.

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