We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Home Overnight Gas Exchange for Long-Term Noninvasive Ventilation in Children.
- Authors
Griffon, Lucie; Touil, Samira; Frapin, Annick; Theo Teng; Amaddeo, Alessandro; Khirani, Sonia; Fauroux, Brigitte
- 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 (SpO2) and transcutaneous carbon dioxide (PtcCO2) 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 SpO2 and PtcCO2 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 SpO2 signal, and 16 (15%) had artifacts on the PtcCO2 signal. Gas exchange abnormalities were observed in 11 subjects with PtcCO2 > 50 mm Hg during ≥ 2% of recording time (n = 8), mean PtcCO2 ≥ 50 mm Hg (n = 6), mean PtcCO2 < 35 mm Hg (n = 3), and SpO2 < 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 SpO2 and PtcCO2 recordings in stable pediatric subjects treated with CPAP/NIV were abnormal and may be corrected by adequate therapeutic interventions.
- Subjects
FRANCE; SLEEP apnea syndrome treatment; CARBON dioxide analysis; ARTIFICIAL respiration; CAPNOGRAPHY; CHI-squared test; HOME care services; OXIMETRY; PULMONARY gas exchange; RESPIRATORY therapy; TRANSCUTANEOUS blood gas monitoring; PULSE oximeters; MECHANICAL ventilators; CONTINUING education units; REPEATED measures design; CONTINUOUS positive airway pressure; DESCRIPTIVE statistics; ONE-way analysis of variance; NASAL cannula; CHILDREN
- Publication
Respiratory Care, 2020, Vol 65, Issue 12, p1815
- ISSN
0020-1324
- Publication type
Article
- DOI
10.4187/respcare.07488