Continued...

Introduction :

What?
The model used must be chosen with regard to type of respiratory failure, correlated to difficulty of diffusing gases or to insufficient ventilation (non-effective respiratory drive (Figure 2) and efficacy of patient's ventilation (assess whether only spontaneous breathing support or complete mechanical control of ventilation is necessary).

Figure 2A - Upper right lobe pneumonia in Spinal Muscular Atrophy type I. Chronic respiratory insufficiency, due to neuromuscular pathology, does not allow a physiological compensation, so that invasive mechanical ventilation was necessary.


Figure 2B- Same case as figure 2A, 48 hours after intubation and mechanical ventilation. Rapid resolution of lung pathology reduces the risk of ventilator dependency, which is common in these little patients. of medical care.

The type of support to apply is to be chosen in relation to the work of breathing which is required of the child, along with his oxygen consumption and compensation possibilities.

How?
Chosen ventilatory strategy must be applied with regard to severity of pathology to be treated, its possible evolution, aim of such treatment, (e.g. avoid chemical pneumonia after aspiration, etc.) and human and technological resources available.

If an ICU is not available, early non-invasive treatment can be suggested so as to reduce need for invasive treatment (intubation and controlled ventilation). Early initiation of treatment has been shown to be the most important factor in improving the final result.