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]