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Research ArticleOriginal Research

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

Lucie Griffon, Samira Touil, Annick Frapin, Theo Teng, Alessandro Amaddeo, Sonia Khirani and Brigitte Fauroux
Respiratory Care December 2020, 65 (12) 1815-1822; DOI: https://doi.org/10.4187/respcare.07488
Lucie Griffon
Pediatric Noninvasive Ventilation and Sleep Unit, Hôpital Necker-Enfants malades, Paris, France.
EA 7330 Vigilance Fatigue Sommeil et Santé Publique, Paris University, Paris, France.
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Samira Touil
Pediatric Noninvasive Ventilation and Sleep Unit, Hôpital Necker-Enfants malades, Paris, France.
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Annick Frapin
Pediatric Noninvasive Ventilation and Sleep Unit, Hôpital Necker-Enfants malades, Paris, France.
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Theo Teng
Pediatric Noninvasive Ventilation and Sleep Unit, Hôpital Necker-Enfants malades, Paris, France.
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Alessandro Amaddeo
Pediatric Noninvasive Ventilation and Sleep Unit, Hôpital Necker-Enfants malades, Paris, France.
EA 7330 Vigilance Fatigue Sommeil et Santé Publique, Paris University, Paris, France.
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Sonia Khirani
Pediatric Noninvasive Ventilation and Sleep Unit, Hôpital Necker-Enfants malades, Paris, France.
ASV Santé, Gennevilliers, France.
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Brigitte Fauroux
EA 7330 Vigilance Fatigue Sommeil et Santé Publique, Paris University, Paris, France.
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  • For correspondence: [email protected]
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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 (Embedded Image ) and transcutaneous carbon dioxide (Embedded Image ) 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.

METHODS: The home overnight Embedded Image and Embedded Image 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.

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 Embedded Image signal, and 16 (15%) had artifacts on the Embedded Image signal. Gas exchange abnormalities were observed in 11 subjects with Embedded Image > 50 mm Hg during ≥ 2% of recording time (n = 8), mean Embedded Image ≥ 50 mm Hg (n = 6), mean Embedded Image < 35 mm Hg (n = 3), and Embedded Image < 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).

CONCLUSIONS: A significant number (∼12%) of systematic home Embedded Image and Embedded Image recordings in stable pediatric subjects treated with CPAP/NIV were abnormal and may be corrected by adequate therapeutic interventions.

  • noninvasive ventilation
  • continuous positive airway pressure
  • home
  • child
  • gas exchange
  • pulse oximetry
  • transcutaneous carbon dioxide monitoring

Footnotes

  • Correspondence: Brigitte Fauroux MD, Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hopital Necker, 149 rue de Sèvres, Paris, 75015 France. E-mail: brigitte.fauroux{at}aphp.fr
  • The authors have disclosed no conflicts of interest.

  • Copyright © 2020 by Daedalus Enterprises
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Respiratory Care: 65 (12)
Respiratory Care
Vol. 65, Issue 12
1 Dec 2020
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Home Overnight Gas Exchange for Long-Term Noninvasive Ventilation in Children
Lucie Griffon, Samira Touil, Annick Frapin, Theo Teng, Alessandro Amaddeo, Sonia Khirani, Brigitte Fauroux
Respiratory Care Dec 2020, 65 (12) 1815-1822; DOI: 10.4187/respcare.07488

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Home Overnight Gas Exchange for Long-Term Noninvasive Ventilation in Children
Lucie Griffon, Samira Touil, Annick Frapin, Theo Teng, Alessandro Amaddeo, Sonia Khirani, Brigitte Fauroux
Respiratory Care Dec 2020, 65 (12) 1815-1822; DOI: 10.4187/respcare.07488
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Keywords

  • noninvasive ventilation
  • continuous positive airway pressure
  • home
  • child
  • gas exchange
  • pulse oximetry
  • transcutaneous carbon dioxide monitoring

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