Paediatric long term continuous positive airway pressure and noninvasive ventilation in France: A cross-sectional study.

Objective: To describe the characteristics of children treated with long term continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) in France.
Design: Cross-sectional national survey.
Setting: Paediatric CPAP/NIV teams of 28 tertiary university hospitals in France.
Patients: Children aged <20 years treated with CPAP/NIV since at least 3 months on June 1st, 2019.
Intervention: An anonymous questionnaire was filled in for every patient.
Results: The data of 1447 patients (60% boys), mean age 9.8 ± 5.8 years were analysed. The most frequent underlying disorders were: upper airway obstruction (46%), neuromuscular disease (28%), disorder of the central nervous system (13%), cardiorespiratory disorder (7%), and congenital bone disease (4%). Forty-five percent of the patients were treated with CPAP and 55% with NIV. Treatment was initiated electively for 92% of children, while 8% started during an acute illness. A poly(somno)graphy (P(S)G) was performed prior to treatment initiation in 26%, 36% had a P(S)G with transcutaneous carbon dioxide monitoring (PtcCO ₂ ), while 23% had only a pulse oximetry (SpO ₂ ) with PtcCO ₂ recording. The decision of CPAP/NIV initiation during an elective setting was based on the apnea-hypopnea index (AHI) in 41% of patients, SpO ₂ and PtcCO ₂ in 25% of patients, and AHI with PtcCO ₂ in 25% of patients. Objective adherence was excellent with a mean use of 7.6 ± 3.2 h/night. Duration of CPAP/NIV was 2.7 ± 2.9 years at the time of the survey.
Conclusion: This survey shows the large number of children treated with long term CPAP/NIV in France with numerous children having disorders other than neuromuscular diseases.
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