Evaluate The Effect Of BiPAP Noninvasive Ventilation For Children Suffering From Congenital Heart Disease With Cardiopulmonary Insufficiency

Objective: Apply BiPAP noninvasive ventilation on the children suffering fromcongenital heart diseas（eleft to right shunt type）with cardiopulmonary insufficiency. Byobserving the changing condition of respiratory function and cardiac function of thechildren before and after applying BiPAP, evaluate the curative effect and safety ofBiPAP noninvasive ventilation on children suffering from congenital heart disease（left toright shunt type） with cardiopulmonary insufficiency.Method: select17children hospitalized in PICU of our hospital from Dec2013to Mar2014, who were suffering from congenital heart disease（left to right shunt type）withcardiopulmonary insufficiency and treated with BiPAP noninvasive ventilation. Monitorvital signs and blood gas analysis before BiPAP noninvasive ventilation and2h,12h,24h,72h,5d and7d after that. Grade improving Ross and NYU PHFI and monitorNT-proBNP, CTnI, color Doppler ultrasound (Tei index, LVEF, LVFS) index beforeBiPAP noninvasive ventilation and5d after that. Divide them into BiPAP noninvasiveventilation success group and failure group according that if it has been changed toinvasive mechanical ventilation. Have a retrospective analysis on the occurrence rate ofVentilator Associated Pneumonia (VAP) of children hospitalized in PICU of our hospitalsuffering from congenital heart disease from Jan2013to Feb2014, who were givennoninvasive ventilation or invasive mechanical ventilation.Result:(1)2h after BiPAP noninvasive ventilation, the breath, heart rate andtranscutaneous oxygen saturation (SpO2) have improved evidently (RR p=0.001;HRp=0.013; SpO2p=0.011). The positive rate of three depressions sign has decreasedevidently since12h (p=0.005).(2) Compared with that before BiPAP noninvasiveventilation, CTnI and NT-proBNP have decreased evidently (p=0.027；p=0.028)5d after BiPAP noninvasive ventilation. Color Doppler ultrasound Tei index has decreasedevidently, and its result has statistical difference (P=0.015); the improving Ross gradeand NYU PHFI grade have improved markedly before and after BiPAP noninvasiveventilation.(the improving Ross grade p=0.000; NYU PHFI grade p=0.027).(3)17children have no common complications of noninvasive ventilation; from Jan2013toFeb2014, the occurrence rate of noninvasive ventilation VAP is0%(0/37), and theoccurrence rate of invasive mechanical ventilation VAP is5.62%(5/89).Conclusion:(1) Applying BiPAP noninvasive ventilation on the children sufferingfrom congenital heart disease （left to right shunt type） with cardiopulmonaryinsufficiency can effectively improve respiratory function and cardiac function. Thesuccess rate is76.5%.(2) Tei index is better than LVEF and LVFS at comprehensiveassessment of systolic and diastolic functions of left ventricular.