Criteria for Chronic Respiratory Failure in Infants and Children

Criteria for Chronic Respiratory Failure due to Cardiopulmonary Disorders in Infants and Children

Clinical criteria

• Decreased inspiratory breath sounds
• Increased retractions, use of accessory muscles
• Cyanosis breathing room air
• Decreased level of normal activity/function
• Poor weight gain (mass) (IMPORTANT)

Physiological criteria

• PaCO₂ > 45 mm Hg
• PaO₂ < 65 mm Hg
• Oxygen saturation < 95% breathing room air

Criteria for Chronic Respiratory Insufficiency Due to Central Nervous System, Neuromuscular, and Skeletal Conditions in Infants and Children

Clinical criteria

• Weak cough
• Retained airway secretions
• Increased use of accessory muscles
• Incompetent swallowing
• Weak or absent gag reflex
• Decreased level of normal activity/function (IMPORTANT)

Physiological criteria

• Vital capacity < 15 mL/kg
• Inspiratory force < 20 cm H₂0
• PaCO₂ > 40 mm Hg
• PaO₂ < 70 mm Hg
• Oxygen saturation < 97% breathing room air

References:

1. Nørregaard O. Noninvasive ventilation in children. Eur Respir J. 2002 Nov;20(5):1332-42. [Medline]