Start Over

Home Overnight Gas Exchange for Long-Term Noninvasive Ventilation in Children.

Authors :: Griffon L
Touil S
Frapin A
Teng T
Amaddeo A
Khirani S
Fauroux B
Source :: Respiratory care [Respir Care] 2020 Dec; Vol. 65 (12), pp. 1815-1822. Date of Electronic Publication: 2020 Jul 28.
Publication Year :: 2020
Abstract: Background: The aim of CPAP and noninvasive ventilation (NIV) is to correct sleep-disordered breathing and nocturnal gas exchange. The aim of the study was to analyze the results of a systematic home pulse oximetry ([Formula: see text]) and transcutaneous carbon dioxide ([Formula: see text]) monitoring in stable pediatric subjects on long-term CPAP/NIV or screened for CPAP/NIV weaning, and the consequent interventions in the subjects with abnormal gas exchange.<br />Methods: The home overnight [Formula: see text] and [Formula: see text] recordings of stable pediatric subjects treated with or weaned from CPAP, NIV, or high-flow nasal cannula between January 2017 and March 2018 were analyzed.<br />Results: A total of 110 recordings, performed in 79 subjects, median age 6 (interquartile range [IQR] 1.5-14) y, were analyzed. Fifty-two recordings (47%) were performed during NIV, 43 (39%) during CPAP, 2 (2%) during high-flow nasal cannula, and 13 (12%) during a spontaneous ventilation weaning trial from ventilatory support. The quality of recording was excellent in 81% of recordings, 5 recordings (5%) had <4 h of recording time, 5 (5%) had artifacts on the [Formula: see text] signal, and 16 (15%) had artifacts on the [Formula: see text] signal. Gas exchange abnormalities were observed in 11 subjects with [Formula: see text] > 50 mm Hg during ≥ 2% of recording time ( n = 8), mean [Formula: see text] ≥ 50 mm Hg ( n = 6), mean [Formula: see text] < 35 mm Hg ( n = 3), and [Formula: see text] < 90% during ≥ 2% of recording time ( n = 2). Consequent interventions were (multiple interventions possible): change of device settings ( n = 6), change of interface ( n = 2), switched to high-flow nasal cannula ( n = 1), and a control recording ( n = 2).<br />Conclusions: A significant number (∼12%) of systematic home [Formula: see text] and [Formula: see text] recordings in stable pediatric subjects treated with CPAP/NIV were abnormal and may be corrected by adequate therapeutic interventions.<br /> (Copyright © 2020 by Daedalus Enterprises.)