A Systematic Review on the Effectiveness and Safety of Non-Invasive Ventilation (CPAP, BiPAP, and HFNC) for Acute Respiratory Distress in Pediatric Emergency Care
DOI:
https://doi.org/10.56294/saludcyt20252352Keywords:
Acute Respiratory Failure, CPAP, HFNC, BiPAPAbstract
Introduction: Non-invasive ventilation therapies such as Continuous Positive Airway Pressure (CPAP), High Flow Nasal Cannula (HFNC), and Bilevel Positive Airway Pressure (BiPAP) are commonly used in children with acute respiratory failure and adult ICU patients. However, the effectiveness and tolerability of each method remain a subject of debate.
Objective: This systematic review compares the effectiveness, safety, and comfort of using CPAP, HFNC, and BiPAP in pediatric patients with respiratory disorders and adult patients with acute respiratory failure in the ICU.
Method: included randomized controlled trials (RCTs), observational cohort studies, and retrospective studies comparing CPAP, HFNC, and BiPAP in pediatric and adult populations. Data on treatment outcomes, failure, physiological parameters, patient comfort, and mortality were systematically analyzed.
Results: CPAP tends to improve acid-base parameters (pH, PCO₂, P/F ratio) more quickly than HFNC, but HFNC provides better oxygen saturation (SpO₂, PaO₂) and higher patient comfort. The rate of CPAP treatment failure is lower than that of HFNC, though not significantly so. In patients with severe bronchiolitis, HFNC is more tolerable with fewer side effects. In COVID-19 ICU patients, BiPAP and CPAP have equivalent efficacy and safety with no significant differences in mortality and treatment failure. Pre-hospital NIV therapy is also proven to be safe and effective.
Conclusion: CPAP and HFNC are both effective for treating respiratory failure in children, with CPAP providing faster physiological improvement and HFNC being more comfortable. BiPAP and CPAP are equally effective and safe in adult patients with acute respiratory failure, particularly COVID-19. Therapy selection should consider the patient's clinical condition and tolerability.
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Copyright (c) 2025 Reihan Athala Rizki Putranda, Hadi Suwono (Author)
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