Management of acute exacerbations of pediatric chronic respiratory disease.

In patients with acute exacerbations of chronic obstructive or restrictive pulmonary disease, noninvasive ventilation can be used in an attempt to avo id endotracheal intubation and complications associated with mechanical ven tilation. The main obstructive pathology concerned is bronchopulmonary dysp lasia: bronchial hyperreactivity is a main feature of the situation, leadin g eventually to acute or prolonged assisted ventilation. Usually performed by tracheostomy; ventilation can possibly be managed through a nasal mask. The use of noninvasive ventilation is also indicated when symptoms of hypov entilation and daytime hypercarbia develop in a variety of neuromuscular di sorders. (C) 2000 Editions scientifiques et medicales Elsevier SAS.