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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Acute Lung Injury, Adolescent, Child, Child, Preschool, Cohort Studies, Confidence Intervals, Female, Forecasting, Humans, Intensive Care Units, Pediatric, Multiple Organ Failure, Odds Ratio, Positive-Pressure Respiration, Prognosis, Respiratory Distress Syndrome, Adult, Retrospective Studies.
user
Does the number of failing organs predict non-invasive ventilation failure in children with ALI/ARDS? Context: Non-invasive positive pressure ventilation (NIV) is being increasingly used in paediatric critical care, although its use in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) is still debated. No definite data are available for the prediction of NIV outcome in such selected populations. We aimed to identify which factors might affect NIV failure in paediatric ALI/ARDS patients. A retrospective cohort study using comprehensive predictivity analysis was performed. All children admitted to our paediatric intensive care unit over a 4-year period for ALI/ARDS were reviewed. Basic, clinical, physiological parameters and their change after 1 h of NIV were considered and subjected to univariate analysis. Candidate prognostic variables were then subjected to multicollinearity scrutiny and logistic regression. Finally, variables significant in the logistic regression were subjected to predictivity analysis. The number of organ failures at admission (NOF) is a strong predictor of NIV failure (odds ratio 5.26; p = 0.004). Having only one organ failure provides a probability of NIV success of 85.7% (sensitivity 87%; specificity 49%). One NIV failure will be predicted and avoided for every four cases in which the presence of other organ failures is incorporated into the clinical decision.
assistant
NOF significantly predicts the NIV failure. Children with no organ failures other than ALI/ARDS may safely be treated with NIV. Final Decision: yes