Abstract
We present two infant cases where noninvasive positive pressure ventilation (NPPV) worked effectively as a weaning strategy after prolonged mechanical ventilation. Case 1: An 11-month-old girl was admitted to our unit because of cardiac failure due to congenital mitral regurgitation. Her trachea was intubated and ventilated for 33 days. After the extubation, she suffered from tachypnea and increasing tracheal secretion. NPPV [continuous positive airway pressure (CPAP) mode; PEEP 4 cmH2O; FIO2 0.3] was applied and she was weaned from NPPV successfully 28 days later. Case 2: A 10 month-old girl developed an upper respiratory tract infection and obliterative bronchitis. She had undergone Blalock-Taussig shunt and uniforcalization for double outlet right ventricle, pulmonary atresia and major aortopulmonary collateral arteries at 1 month old. Her trachea was intubated and ventilated for 24 days. Applying NPPV (CPAP mode; PEEP 5 cmH2O; FIO2 0.4) soon after the extubation of her trachea, she needed re-intubation. On the 37th in ICU day, her trachea was extubated again and immediately applied NPPV [spontaneous and timed (S/T) mode; expiratory positive airway pressure (EPAP) 4 cmH2O; inspiratory positive airway pressure (IPAP) 6 cmH2O; FIO2 0.4]. She was weaned from NPPV successfully 4 days later. In conclusion, NPPV was also useful tool for infants who were difficult to wean from prolonged mechanical support.
